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THE 

AMERICAN 

OR, 

MEDICAL ADMONISHER: 

C0XT4J5TXG 

SOME ACCOUNT 

OF 



ANATOMY, 
THE SENSES, 
DISEASES, 



CASUALTIES; x 
DISPENSATORY, and 
GLOSSARY. 



EST WHICH 

The Observations, and Remedies, are adapted to the Diseases, Sfc, 

OF THE 

UNITED STATES. 

DESIGNED FOR THE USE OF FAMILIES. 

— 

SECOND EDITION, WITH ADDITIONS AND IMPROVEMENTS. 



BY HORATIO GATES* JAMESON, M.D. 

Honorary Member of the Medical Society of Maryland, and late a Surgeon in the 
General Hospital for the Army at Baltimore. 



V 



BALTIMORE: 

PUBLISHED BY THE AUTHOR. 

JOHN D. TOT, PRINTER. 

1818. 






District of Maryland, ss. 

BE IT REMEMBERED, That on this seventeenth day of February, in the 
v.******** forty-second year of the Independence of the United States of America, 
1 ± Horatio Gates Jameson, of the said District, hath deposited in this office 

£ seal. * t ^ e t - t j e j a boo]^ ^g right whereof he claims as author; in the words 
*♦*♦ »»♦♦'* following, to wit: 

"The American Domestick Medicine; or, Medical Admonisher: containing som- 
account of Anatomy, The Senses, Diseases, Casualties; a Dispensatory, and Glossary, 
in which the Observations, and Remedies, are adapted to the Diseases, &c. of the 
United States. Designed for the use of families. Second edition, with additions and 
improvements. By Hoi^atio Gates Jameson, M. D. Honorary Member of the Medi- 
cal Society of Maryland, and late a Surgeon in the General Hospital for the Army at 
Baltimore." 

In conformity to the act of the Congress of the United States, entitled , "An act for 
the encouragement of learning, by securing the copies of maps, charts ad books, to 
the authors and proprietors of such copies during the times therein mentioned." And 
also to the act, entitled, "An act supplementary to an act, entitled, 'An act for the 
encouragement of learning, by securing the copies of maps, charts, and books, to the 
authors and proprietors of such copies during the times therein mentioned,' and ex- 
tending the benefits thereof to the 4 ,arts of designing, engraving, and etching historical 
and other prints." 

PHnJP MOORE, 
Clerk of the District of Maryland. 






I 



RECOMMENDATIONS 



IN compliance with custom, the publisher of this work 
requested a few of the most eminent professional men 
to give their opinion of it. The following highly re- 
spectable reviews of it have been obtained. 

DR. JAMESON, 

^ r R — As popular treatises on diseases will be al- 
much used, and are often indispensable, it is im- 

ant to give to them the progressive improvements in 
.dicine. In this view your book seems to merit, and 
no doubt will acquire, a liberal patronage. To the 
usual materials of such productions, you have added 
later facts and observations from the best authorities, in- 
cluding your own, and given to the whole, a method and 
style well adapted to their purpose. On the means of 
preserving health, you dwell to advantage, since that, 
more than the cure of diseases, is within the comprehen- 
sion and control of your readers, and since our climate 
and mode of living, give to it particular importance. 

Your sketches of the structure and laws of the human 
body, and application of them to the use of remedies, 
connect science with experience, and indicate the only 
safe principles on which diseases can be treated — thus 
combining throughout your work, utility and security., 
with commendable success. 

July 1st, 1817. JOHN OWEN. 



Sir, 
I have examined with as much attention as my time 
would admit, your book, entitled, "The American Do- 
mestick Medicine, or Medical Admonishes" I am 



IV 

much pleased with the design, and (with lew excep- 
tions) the ability of the work. It is executed with a 
pious zeal for the benefit of mankind, and is replete 
with useful instruction and entertainment to the gentle- 
man and scholar. Your Dispensatory at the end of the 
book will be highly useful and convenient in families, 
and the Glossary will make the whole intelligible to 
every reader of common understanding. 

I am, respectfully, your obed't, humble serv't, 

JOHN COULTER. 
Dr. Horatio Gates Jameson. 
March 15, 1817. 



Baltimore, March 12th, 1817. 
Dear Sir, 
I have perused your Domestick Medicine with plea- 
sure, and have no hesitation in saying, it is one of the 
best productions of the kind which 1 have seen. You 
deserve much credit for your industry and pains in com- 
piling a work which is calculated to do much good. I 
hope you will be amply remunerated for your difficult 
and arduous undertaking. 

I am, with respect, your obed't, humble serv't, 

JOHN CROMWELL. 
Dr. Horatio G. Jameson. 



Baltimore, Feb. 16, 1818. 
Dear Sir, 
Having perused the American Domestick Medicine 
published by you, am of opinion that it is a work of 
much merit, and equal, if not superiour, to any work of a 
similar description I have met with, and well deserving 
publick attention and patronage; and will, I think, be 
particularly valuable to those* gentlemen who reside in 
the country, removed at a distance from a physician. 
The arrangement I think judicious, and the prescript 



tions will be generally found useful and proper in the 
diseases for which they have beeu recommended. 
I remain, very respectfully, yours, &c. 

JAMES SMYTH, 
Br. Horatio Gates Jameson. 



Dear Sir, 



Baltimore, Feb. 16, 1818. 



We have perused your book, entitled, "The Ameri- 
can Domestic k Medicine/' with much pleasure and sa- 
tisfaction. The arrangement is highly judicious, and 
we sincerely hope, you will be amply remunerated for 
the trouble you have encountered, and for the time you 
have expended in the composition of the work. 
We are, dear sir, yours, very respectfully, 

BROWN & MACKENZIE. 
Br. Jameson. 



Pastoral-House, East street, June 17, 1817- 
Dear Sir, 
Agreeably to your request signified to me some time 
since, I have perused your volume recently published, 
under the title of "The American Domestick Medicine, 
or Medical Admonisher;" and, although I should deem 
it presumption in me to pass any opinion on its merits as 
ar professional or scientiiick work; I can have no hesita- 
tion in acknowledging with pleasure what I may be sup- 
posed more competent to discern; I mean its moral ten- 
dencies. To my best apprehension, your book is auxi- 
liary to the soundest principles of religion and virtue 
If the expression of this sentiment shall be of any ser- 
vice to you in the disposal of your publication, it will 
impart great pleasure, dear sir, to your friend and ser- 
vant, 

JAMES INGrLIS; 
Br. Horatio Gates Jameson 



INTRODUCTION 



THE author, in presenting this volume to the publick, 
begs leave to call the attention of its readers, to the cir- 
cumstance of the very limited number of Original Works 
in the United States. The subject here treated of, is 
certainly highly important, and strongly claims the at- 
tention of every intelligent person. 

The foregoing highly respectable recommendations 
were bestowed on the first edition; and as the work has 
undergone a careful revision, and appears now with some 
additions, and improvements, it is hoped it will not be 
deemed either arrogant or false to say, that this work is 
an improvement upon all that have preceded it. 

Among the additions may be mentioned an alphabeti- 
cal index, which will greatly assist the reader in finding 
what may be wanted suddenly. But, it is confidently be- 
lieved, most persons will find some amusement and in- 
struction in perusing these sheets, either by finding some- 
thing new, or refreshing the memory in what may be al- 
ready known. To an enlightened and liberal publick 
the author now appeals, with a confidence reafcoflably 
arising from ample opportunity of understanding the 
subject. 



EXPLANATION OF THE PLATE. 



THE design is from a picture in the possession of my 
brother, Dr. Jameson, of York, Pennsylvania. It re- 
presents the celebrated Galen, viewing a human skele- 
ton, of whom it is saiuHhat, "Though an Atheist, he was 
a strict observer of nature, till by chance finding a skele- 
ton, he thought it of too curious a construction to be the 
work of chance." The vast and sudden expansion of 
his views of the Deity, in the following lines, while they 
agreeably surprise us, are a strong confirmation of the 
existence of a "light," in the human capacities, "which 
lighteth every man." 

"Forbear, vain man, to launch with reason's eye, 

Through the vast depth of dark immensity; 

Nor think thy narrow, but, presumptuous mind, 

The least idea of thy (rod can find. 

Thought, crowding thought, distracts the laboring brain; 

For how can finite infinite explain? 

Then God adore, and conscious rest in this, 

None, but Himself, can paint him as He is." 



TABLE OF CONTENTS 



1st PART— of ANATOMY. 

Page. 

Sect. 1. of the Skin - - - - 17 

2. of the Bones or Skeleton - - - -.20 

S. of the Cartilage or Gristle 26 

4. of the Ligaments - - - - - 27 

5. of the Muscles - - - - - ib. 

6. of the Muscles within the body - - - 29 

7. of the Arteries ----- SO 

8. of the Brain - - - - - « . - 31 

9. of the Circulation - - - - S3 

10. of the Blood -, - - - - 35 

11. of the Glands - - - - 36 

12. of the Viscera - - - - - ib. 

13. of the necessary distinction of Parts - - S9 

and a Recapitulation of this part - - 41 

2d PART— of the SENSES. 

Sect. 1. of the Sense of Touch - - - - 44 

2. of the Sense of Taste 45 

3. of the Sense of Smelling - - - - 47 

4. of the Sense of Hearing i b. 

5. of the Sense of Seeing - - - - 49 

6. of the Senses in general 52 

7. of the Cause of Animal Life - - - 53 

8. of the Mind 55 

9. Summary of Physiological Sketches - - 56 

3d PART— of the NONNATURALS. 

Sect. 1. of the Air - - - - - - 58 

2. of Aliment - - - - 62 

3. of Sleep 74 

4. of Clothing - - - - - 76 

5. of Exercise - - - - - 78 

% 



X CONTENTS. 

Page. 

Sect 6. of the Secretions ----- 82 

7. of the Passions - - - - •? ib. 

4th PART—OF the PULSE. 85 

5th PART—of BLEEDING. 

Sect. 1. of Bleeding by the Lancet - - - 98 

2. of Arteriotomy - - *- - 100 

3. of Bleeding by Leeches - - - ib. 

4. of Cupping - - - - 102 

5. of Scarifying - - - - - 103 

6th PART— of DISEASES. 

Sect 1. of Nosology - - - - - 103 

2. of Diseases of excessive excitement - 105 

3. of Diseases of Abstraction ... 106 

4. of Epidemicks - - <■ - - 108 

5. of Endemicks - - - - - 111 

6. of Contagious diseases - - - ib. 

7. of Fortuitous diseases - - - - 112 

8. of Habitual diseases - - - 113 

9. Summary of general observations - - 1 14 

7th PART— of EPIDEMICKS INDIVIDUALLY. 

Sect. 1. of the Yellow Fever - - - 118 

Letters from Dr. Drysdale to Dr. Rush - - 120 

Concluding advice on Yellow Fever - - 141 

2. of the Bilious Remitting Fever - 145 

3. of the Influenza - - - - 147 

4. of Typhus and Typhoid fevers - 148 

5. of the Measles ----- 151 

6. of the Hooping-Cough - - - - 154 

7. of the Scarlatina, or Malignant Sore Throat - 155 

8. of the Dysentery or Bloody Flux - - 157 

9. of the Ague or Intermitting Fever - - 162 

8th PART— of CONTAGIOUS DISEASES. 

Sect. 1. Admonitory Remarks on Smallpox - - 164 

2. of the Smallpox - - - - 165 

9th PART— of FORTUITOUS DISEASES. 

Sect. 1. of Consumption of the Lungs - - - 167 

2. of the Peripneumony - - - - 179 

3. of the Pleurisy - - - - - 181 

4. of the Croup or Hives - 183 

5. of a Common Cold - - - - 185 

6. of Inflammation of the Stomach - - - 186 



CONTENTS. Xi 

Page. 

Sect 7. of Inflammation of the Intestines - - - 187 

8. of Inflammation of the Kidneys - - - 188 

9. of Inflammation of the Bladder - - 189 

10. of Inflammation of the Diaphram - - 190 

11. of Inflammation of the Peritoneum - - ib. 

12. of Inflammation of the Liver - - - 191 

13. of Inflammation of the Brain - - 193 

14. General observations on Visceral Inflammation - 195 

15. of Erysipelas - - - - 198 

16. of the Scarlet Fever - - - S00 

17. of the Chickenpox ----- 201 

18. of the Quinsey - - - - - ib. 

19. of the Mumps - 203 

20. of the Miliary Fever - ib. 

21. of Malignant Fever from Local Causes - - 204 

22. of Typhus Fever from Local Causes » «- 207 

23. of a Simple Inflammatory Fever -» - 209 

24. of the Dropsy - - - - - 210 

25. of the Rheumatism - - - - 216 

26. of the Apoplexy - - * - - * 217 

27. of the Palsy - - - - - 218 

28. of the Locked Jaw, or Tetanus - •» 219 

29. of the St. Vitus's Dance - - - 222 

30. of the Hydrophobick Fever - 223 

31. of the Scurvy - 233 

32. of the Jaundice - 234 

33. of a Diabetes ----- 235 

34. of Madness or Insanity - 237 

35. of the Cholera Morbus - - - - 243 

36. of Colick in General - 244 
of the Lead Colick - - - - 245 
of the Flatulent Colick - 246 
of the Hysterick Colick - 247 
of the Iliac Passion - - - - 248 
of an Epidemick Colick - - . 249 

37. of a Spitting of Blood from the Lungs - - 250 
of a Spitting of Blood from the Stomach - 252 

38. of Bloody Urine < - - - - - ib, 

39. of Bleeding at the Nose ... 253 

40. General observations on Hemorrhage - - 254 

41. of a Vomiting - 257 

42. of a Diarrhoea and Lientery - 260 

43. of a Gonorrhoea or Clap - * •* ' ' 262- 

44. of Inflammation and Swelling of the Testes - - 263 

45. of a Gleet ----- 264 

46. of Onanism, or Self-Pollution - - ib. 

47. of Phymosis and Paraphymosis - - - 265 

48. of Drunkenness or Self-Debasement - * 266 

49. of Headach ----- 269 
£0. of Toothach - v . .- - - cg\ 



XII 



CONTENTS, 



Sec. 51. of Earach - 

52. of Inflammation of the E jes 

53. of Want of Appetite - 

54. of Heartburn and Waterbrash 

55. of Hickup - 

56. of Cramp of the Stomach 

57. of the Nightmare, or Incubus 

58. of Swoonmgs, or Faintings - 

59. of Flatulence, or Windy Bowels 

60. of Chilblains and Kibes 

61. of Herpes, in general - 

62. of the Scaldhead - - 

63. of Pimples in the Face - 

64. of the Itch - 

65. of Prickliheat - 

66. of the Yellow Morphew 

67. of the Leprosy - 

68. of Worms - 

69. of a Strangury - - - - 

70. of Ischuria - 

71. of Eneuresis, or Habit of Wetting the Bed 

72. of Gutta Serena - 
of Cataract - 

of Strabismus, or Squinting - 

of Specks, or Films upon the Eyes 

of the Blood-shot Eye 

of the Watery or Weeping Eye 

of Deafness - 

of Loss of the Taste - 

of the Loss of Smell 

of the Loss of the Sense of Touch 



Page. 
27S 
274 
276 
277 
278 
279 
280 
282 
28S 
284 
286 
287 
288 

ib. 
290 

ib. 
291 
292 
294 
295 

ib. 
296 
297 
298 

ib. 
299 

ib. 
300 
302 

ib. 
303 



10th PART— of HABITUAL DISEASES. 

Sect. 1. Legitimate Gout - - - S04 

Vibrating Gout - 310 

2. Irregular Gout - - - - ib. 
of Gout in the Kidneys - - * - 312 
of Gouty Gonorrhoea - - - • ib. 
of Gout in the Testes - - - - 313 
of Gout in the Hip - - - - ib. 
of the Different Grades of Gout - - 314 
General observations on Gout - - 316 

3. of Cluonick Rheumatism - - - 319 

4. of Asthma ----- 320 

5. of Angina Pectoris - 324 

6. of the Gravel and Stone - - - - 326 

7. of Dyspepsia - - - - - 328 

8. of Goitre - - 330 

9. of Scrofula 331 



contents. xiii 

Page. 

Sect. 9* of Rickets 332 

of Malignant Rickets 333 

of Scrofula in the Glands - - - - 334 

of Cancer - 335 

10. of Syphilis, or Lues Venerea ... 336 

11. of the Yaws - - - - 340 

12. of Epilepsy ----- 341 

13. of Hypochondriasis - 343 

14. of Hystericks - - - - - 347 

15. of the Piles or Hemorrhoids 349 

16. of the Fistula in Ano - - - - 352 

17. of Land Scurvy - - • 353 

18. of Corns - 354 

11th PART— of CASUALTIES. 

Sect. 1. of Dislocations in general - 355 

of Dislocation of the Jaw - 356 

of Dislocation of the Shoulder - S57 

of Dislocation of the Wrist 358 

of Dislocation of the Neck - - ib. 

2. of Strains - - - - 359 

3. of Fractures or Broken Bones - - - 360 

4. of Wounds which heal by the First Intention - 363 
of Wounds which should Suppurate - - 367 
of W^ounds which Bleed - 368 
of Bruises r 370 

5. of Ruptures - - - - - 372 

6. of Burns and Scalds - - - - 374 

7. of Frost Bites ----- 376 

8. of Disorder from Drinking Cold Water - - 378 

9. of Drowning or Submersion - - 381 

10. of Hanging, &c. - - - - - 384 
Concluding Advice on Suffocation - - 389 

11. of Substances Stopped in the Throat - - 391 

12. of Swallowing Cents, &c. - 396 

13. of Substances getting into the Windpipe - - 397 

14. of Fish-Hooks, &c. - - - 398 

15. of Extraneous Bodies in the Nose and Ears - - 399 

12th PART— of INFLAMMATION,^ PHLOGOSIS. 

jSect. 1. of Inflammation in General - - - 401 

2. of Mortification - - - - 403 
of Mortification in the Mouth - - - - 405 
of Mortification in the Toes - ib. 

3. of Psoas Abscess ----- 406 

4. of Biles, or Phlegmon - * - - 407 

5. of Inflammation of the Breasts, or Mammae - ib. 

6. of Inflammation of the Nipples - 408 

7. of Inflammation of tl>e Finger, or Felon - - 409 



XIV CONTENTS. 

JPage. 
Sect. 8. of Stonebruises and Bloodbiles - - - 410 
9. of Inflammation from the Bite of the Viper » 411 
of Inflammation from Bite of Rattlesnake and Copper- 
head - ib. 
of the Stings of Insects - - - 413 
10. of Mineral and Vegetable Poisons - - 414 

13th PART— of the FEMALE HABIT. 

Sect. 1. Introductory Remarks on the Menses - - 416 

2. of the Menses ----- 420 

3. of the Appearance and Disappearance of the Menses 423 

14th PART~of a DISEASED STATE of the MENSES. 

Sect. 1. of Painful Menstruation - 424 

of the Treatment of Painful Menstruation - - 427 

2. of a too Sparing Condition of the Mense3 - 429 

3. of Excessive Menstruation - 430 

4. of Retention or Total Absence of the Menses - 431 

5. of the Final Cessation of the Menses - - 432 

15th PART— of PREGNANT WOMEN. 

Sect. 1. of Introductory Remarks - 433 

2. of the Advantages of Exercise - 434 

3. of the Diseases of Gestation and the usual remedies > 

in the Early Months $ 

of Sickness and Vomiting ... 436 

of the Heartburn * ib. 

of Irregularity of the Bowels - - - 437 

of Longings - - - - - i&. 

of Swelling, and Pains in the Breasts - - 438 

of Hysterick Fits and Faintings - 439 

of Wrong Position of the Womb - - 440 

4. of Costiveness, &c. in the Latter Months - 441 
of Piles or Hemorrhoids - ib. 
of Swellings of the Belly, Thighs, &c. - - 442 
of Pains in the Back, Belly, &c. - - ib. 
of Cough and Difficulty of Breathing - * ib. 
of Cramps ----- 443 
of Colick Pains - - - - ib. 
of Suppression of Urine ... 444 
of Incontinence of Urine - 445 

16th PART— of PARTURIENT WOMEN. 

Sect. 1. Introductory Remarks - 445 

2; of the Diseases of Parturient Women - - 449 

of Chills ib. 

of Afterpains ----- ib. 

of Puerperal Fever ----- 450 



435 



CONTENTS. 



XV 



466 
469 
475 

474 



Sect. 2. of Vomiting - . , . . P ^q 

3. Concluding advice to Parturient Women - - jk 

17th PART— of DISEASES of the FEMALE. 

Sect. 1 . of Inflammation of the Uterus - 455 

2. of the Prolapsus Uteri, or Falling Down of the Womb 456 

3. of the Chlorosis, or Green Sickness - - 4^7 

4. of the Fluor Albus ----- 453 

18th PART— of the DISEASES of CHILDREN. 

Sect. 1. Introductory Remarks - . • . 4 -o 

2. of Common Gripings afi1 

3. of the Yellow Gum - ;?i 

4. of the Red Gum - . _ - " 463 

5. of Inflammation of the Eyes - „ 41 

6. of Aphthae, or Thrush - . I - " 464 

7. of Convulsions - 465 

8. of Cholera Infantum, or Summer Disease 

9. of the Cowpox, or Vaccina - 

10. of Milk Blotches, or Crusta Lactea 

11. of Teething .... 

19th PART— DISPENSATORY, or MATERIA MEDICA. 

Sect 1. List of Medicines, table of Doses, Weights - 477 

2. of Purgatives - ■ - . * V* 
ofLaxttives ... "-12 

3. of Emeticks - . . " ™ 

4. of Sudorificks - . „ ' „ " 1*90 
of Stimulant Diaphoreticks - . - " ' 40* 
of Cooling Diaphoreticks ... 404 

5. of Expectorants - ^n* 

6. of Stimulant Diureticks - VL~ 
of Refrigerant Diureticks - . !ni 

7. of Glysters - P 4 ?, 8 

8. of Evacuant Alteratives . . " -%: 
of Stimulant Alteratives - . 2™ 

9. of Diffusible Stimulants . fc " '3 

10. of Durable Stimulants, or Tonicks - - " vm 

11. of Astringents, or Antihemorrhagicks - . ^ 
of Restnngents * * . ^^ 
of External Astringents ... , , 

12. of Antispasmodic^ . " ™2 

13. of Carminative Stimulants , 5 *Z 
of Carminative Antacids ... ™ 

14. of Febrifuges - . „ _ - 526 

15. of Emmenagoo-ues - - ^^ 

16. of Lithontripticks - . ~ ^ f ?° 
of Antacid Lithontripticks - - * " „ 5 H 



XVX CONTENTS. 

Page, 

See. 16. of Tonick Lithontripticks - - * - 533 

17. of Ophthalmicks 534 

18. of Anodynes ----- 536 

19. of Vermifuges - - - - - 539 

20. of Medicinal Nutrients - - - - 541 

21. of Diluent Drinks 544 
Mild Stimulant Drinks - - - - 545 

Tonick Drinks 546 

Cordial Drinks 547 

22. Ointments 548 

23. Dentrifice 549 

24. Cephalick Snuff ... - ift. 

25. Mouth Water, or Gargles - 550 

26. Poultices ----- ib. 
ST. Gvm Plaster - - - - 552 



THE 



AMERICAN 



OF THE ANATOMY OF THE HUMAN BODY. 

SECTION I. 

THE Anatomy of the human body has been aptly com- 
pared, by the illustrious Bell, to a circle; so that, in our 
efforts at demonstration, it matters but little from what 
point we set out; tracing on the various parts of which 
it is composed, all equally dependant on a certain assem- 
blage of parts and functions, we arrive at the point from 
which we embarked. 

I have deemed it most natural, and equally conve- 
nient with any other course, to commence with the skin, 
it being that part in which all the others are enveloped, 
and which in some measure characterizes the man. The 
art of modern anatomists has discovered the skin to con- 
sist of four lamance, or folds; the cuticle, or scarfskin; 
mucous body, or reticular tissue; cutis vera, or true 
skin; and from this last there is separated a vascular 
membrane, which is the organized surface of the true 
skin. 

The first, or scarfskin, is the outside, and is but a 
thin pellicle, except on particular parts exposed to fric- 
tion. Persons who go barefooted, and those who la- 
bour much with the hands, have this part of the skin 
of great thickness on the soles of the feet, and palms of 
the hands. Nature has wisely provided, even for the 
infant, a greater body of this substance on those parts; 
3 



18 OF THE AN ATOM Y 

thereby evidently fitting liim for the various laborious 
duties which fall to the lot of the mass of mankind. Over 
the body, in general, it serves the purpose of defending 
the true skin, and is that part which we remove by the 
application of blisters. However insensible in general, 
there is a point at which it will resist injuries; by wear- 
ing tight shoes, &c. excrescences, as corns, are formed, 
which become exquisitely sensible, and teach us, togeth- 
er with its regular organization, that it is a living part, 
and of vast importance to the human creature. The 
cause of this disease, appears to me, to be a union of 
the scarf with the true skin, brought about by a long 
continued pressure, by which the mucous body is remo- 
ved or destroyed. Affections of the clavus, or corn kind, 
occur sometimes along the sides of the finger nails, for 
which it is only necessary carefully to pare down the 
hardened skin, leaving the nails untouched with the 
knife, otherwise, you produce deformity, and increase 
the disease. In youth, the scarfskin is thin and smooth, 
in old age it becomes thicker, rough, and disposed to 
furrow. 

The second layer, or mucous body, is endowed with 
organization, being reticular or net-like, and is transpa- 
rent, black, brown, yellow, &c. and gives to the body 
the colour of the European, Negro, Sambo, Mulatto, 
Mustee, &c. This substance is subject to disease, and 
to changes which may comport with the health of the 
person affected, but changing very materially the colour, 
hence the cause of white negroes. It is highly proba- 
ble this part of the skin at times acquires considerable 
acrimony, which may arise either from disease in itself, 
or be the consequence of vicious secretions of the glands, 
or vessels of the skin. This organized membraneous 
mucous appears to be much affected in leprosy, plica 
polonica, and tinea capitis, or scaldhead. 

Naturalists, and others, have been much engaged in 
dispute about the cause of this interesting colouring mat- 
ter. Many ascribe it to the effects of climate, and other 
causes arising from filthy habits. It appears to be an 
unnecessary inquiry, as we find many virtues, and bright 
intellectual powers enclosed within the black, or eo- 



OF THB HUMAN BODt. 19 

loured skin; and those who really believe in Revelation 
must admit, that we are all from one common pareat, 
and it matters little whether we suppose it the effect of 
climate, or whether we attribute it to some special act of 
the Deity. 

The third, Cutis Vera, or true skin, has considerable 
body and strength, and is endowed with a large share 
of sensibility, being furnished with a tissue of nerves in- 
numerable: we cannot touch it with the finest point of a 
needle without causing pain. It in some measure serves 
to brace and give strength to the muscles. The fourth 
or inner layer, being a mere tissue of vessels connected 
with the more dense part of the skin, is merely mention- 
ed as a matter of fact, without pretending to point out its 
particular use, or even its organization. 

The skin then, taken with all its component parts, 
holds a high place among the important organs of the hu- 
man system. The healthy skin covering a healthy body, 
presents to our view, in the pretty cheek, shades of red 
and white, more beautiful than the rose; the evanescent 
shades of which no pencil can trace — To the lip a ruby 
tinct, more beautiful than the coral — To the plump and 
well turned limbs and heaving bosom, a tension and 
smoothness, the master-piece of beauty — To the fingers 
of both sexes, perceptions and skill which afford plea- 
sures, exquisite, rational, ornamental, and useful. Pre= 
cious Robe, what brilliant intellect and virtue has been 
enveloped within thy folds? What mighty deeds have 
the human muscles performed, assisted by this wonder- 
ful covering. The skin being carried over every part as 
a defence, and being furnished with vessels, glands, &c.r 
suitable for carrying on the important processes of sen- 
sible and insensible perspiration, must be acknowledged 
to hold a high place in the living assemblage. For on 
no function of the system are we more dependant for 
health, than that of insensible perspiration, a constant 
discharge through the skin, consisting of worn out parts 
divested of all living principle, and therefore highly 
noxious. Sensible perspiration or sweating, comes in as 
the kind guardian of the labourer's health, when expo- 
sed to the scorching sunj for by its rapid and constant 



g,0 OF THE ANATOMY 

evaporation, the body is cooled several degrees, and is 
kept pliant and healthy. 

Experienced physicians have long been aware of a 
strong connexion or sympathy, between the skin and the 
system generally. It is the most remarkably associated 
with the stomach and lungs; hence the absolute necessity 
of cleanliness. It is true many persons of robust consti- 
tutions, are raised in dirt, and wallow in it during a long 
life of activity. But this only argues, that nature can 
accommodate herself to powerful evils; to the valetudi- 
narian, the idler, and to persons generally, who live in 
an unwholesome atmosphere, nothing can be more hurt- 
ful than filthiness, nothing is a more common passport to 
disease and to death. 

SECTION II. 

I deem it equally natural and convenient, after having 
treated of the general envelope, to enter on the bones, 
and divide the skeleton into its three prominent parts; 
these are the Head, the Trunk, and the Extremities or 
Limbs. And first of the head: This is the Emporium 
of the living system; here, secure in a strong box of 
bone, lies the brain. 

The bones may be divided into those of the head or 
skull-cap, and those of the face. Those of the skull-cap 
are eight in number. 1st. Frontal, forming the forehead. 
Snd. Two Parietal bones, or great side walls of the 
head. 3d. The Occiput, forming all the back part of 
the head, and a considerable part of it attached to the 
neck. 4th. Temporal bones, forming the temple on ei- 
ther side. 5th. Ethmoidal bone. 6th. Sphenoidal bone; 
these two last are difficult to describe. The Ethmoidal 
bone is a small square bone, and divides the hollow of 
the nose from the cavity of the skull. It is perforated 
by the Olfactory nerves in so many places as to give it 
the appearance of a sieve, and hence its name. 

All these bones are joined together with Sutures, so 
called from the bones being indented or dove-tailed into 
each other. The Coronal Suture extends across the head 
almost from ear to ear, and joins the Parietal bones to 



OF THE HUMAN BOD\. 21 

the Frontal. The Lambdoidal Suture runs from behind 
one ear over the head to the other, and in its course some- 
what resembles the letter V. The Sagittal Suture runs 
from the Lambdoidal Suture to the Coronal, joining the 
Parietal bones to each other. The Temporal Sutures 
join the temporal bones to the Frontal, Parietal, and 
Occipital bones. 

There are several other sutures which pass through 
the base of the skull and face, which it is unnecessary 
to describe here. The bones of the head being thus di- 
vided into several pieces, may probably secure the head 
better from injuries, than one entire or solid box of bone. 
But it is in the birth of the child we see the admirable 
wisdom of this contrivance. By long continued pressure 
these bones overlap, and thus lengthen and diminish the 
volume of the head, so as to suffer it to pass through, 
where otherwise the solid head must be the destruction 
of both mother and child. Where the Frontal bone 
meets the Parietal, there is in the infant a considerable 
opening called the FontaneUe, which remains open from 
one to three years. In rickety or scrofulous children, it 
remains long open, and in those affected with the watery 
head, it sometimes dilates to a considerable extent. 

The skull-cap is perforated with a number of holes, 
which serve as outlets to the spinal marrow into the neck, 
and for the nerves, and vessels connecting the head with 
the body. 

The bones of the face are pretty numerous, but being 
all united to form the upper jaw and nose, no benefit can 
arise from an enumeration of them. The upper jaw is 
slightly moveable. 

The under jaw is too familiar as respects its form and 
use, to require any particular description. Each jaw has 
sixteen teeth, the four first in each jaw are called incis- 
or es; the two next canine; the rest molar es; the four 
last of which are named dentes sapientice, because they 
do not arrive till years of discretion. The first six teeth 
in either jaw, have, in general, but one root; the molar es 
have from two to four roots, and are most spread in the 
upper jaw, which seems necessary to fix them securely 
in the spongy bone, of which the jaw bone is in good 
part composed, 



S$ OF THE ANATOMY 

The bones of the trunk are those of the Spine, Pelvis* 
Hibs, and Stern tan; the collar bones and shoulder blades 
belong to the arm. The spine has generally seven bones 
of the neck, twelve of the back, five of the loins; Sa- 
crurn and Coxcygis, are a continuation of the spine, but 
belong particularly to the Pelvis. 

The two first bones of the neck are called Atlas and 
JDentata, and are remarkable for giving the principal ro- 
tatory motion to the head. Those of the back are re- 
markable for their strength, and connexion with the 
heads of the ribs. Those of the loins display the wis- 
dom of the contriver, being possessed of a strength and 
facility of motion truly astonishing, in every position of 
the body. The spine, throughout its whole length, with 
the exception of the Coxcygis, has a considerable chan- 
nel, where the spinal marrow, or elongation of the brain, 
is securely lodged; between the vertebrae, or bones of 
the back, there is a substance in some measure of the 
nature of both cartilage and ligament. This substance 
is so highly elastick as to yield to all the complicated 
motions of the spine, accommodating itself, in a surpri- 
sing manner, to the stooping, twisting, and rapid motions 
of the body. It is a well established fact, that it yields 
during the day to the pressure upon it, and recovers 
during the night, so that we are about an inch taller in 
the morning than at night. By long continued inclina- 
tion forwards, backwards, or sideways, this substance 
accommodates itself to the bend, yielding on one side, 
and enlarging on the other, and if long continued pro- 
duces deformity. 

Some tolerable idea of the human spine may be for- 
med by viewing that of quadruped animals. The ribs 
are usually twelve on either side; seven are called true 
ribs, because they reach the Sternum, or breast-bone; 
the remaining five are called false ribs; these are not 
connected with the Sternum, but are below it, and are 
fastened together by cartilages. The ribs are all, ex- 
cept the two or three lowermost, connected to the bones 
of the spine at two points; and they afford a pretty se- 
cure lodgment to the viscera, and assist largely in the 
process of respiration. 



ijl> THE HUMAN BODY. $£ 

It has been a prevalent opinion that man has an odd 
rib. This supposition is founded on the belief of our 
partaking of Adam's altered form, in giving a rib for his 
mate; but this case is easily reconciled, by supposing 
man was originally formed with an odd one for that very 
purpose; we are not to suppose the work of creation, 
partaking of what we call chance, but that the Creator 
in his wisdom had, from all eternity, provided for every 
possible thing the suitable means. 

The Sternum, or breast-bone, completes the bony fa- 
brick of the Thorax or chest, and lies pretty much over 
the heart. In infancy it is composed of eight pieces, in 
more advanced life it has but three, and in old age it 
becomes one entire piece; even the cartilage with which 
it is connected, becomes bone in many cases; this carti- 
lage, which runs down, shaped somewhat like a sword, 
derives its name from that circumstance, and is called 
ensiform cartilage. To the upper end of the Sternum 
is attached the Clavicula, or collar bone. Having now 
spoken of the Vertebrae, the Ribs, and Sternum, which 
form the Chest, we are regularly brought to the Sacrum 
and Coxcyx, they being the termination of the Spine^ 
and forming a considerable part of the Pelvis. The 
Sacrum forms the back part of the Pelvis, and is a flat 
wedge-like bone; to its lower end is attached the Cox- 
eyx, a small bone composed of several pieces, turning in- 
wards so as to give some support to the parts within the 
Pelvis. In time of labour this bone forms the only 
moveable part of the Pelvis, for by straightening it en- 
larges the lower aperture in a small measure. 

In examining the Pelvis, we are first led to contem 
plate it as a great living arch placed between the trunk 
and lower extremities; it beiug an irregular circle form- 
ed of large solid bones. It has too deep cavities, one on 
either side, they are called Acetabula; these afford a 
deep and firm socket for the head of the thigh bone. In 
the child it consists of many pieces; in the adult they are 
united. The entire Pelvis has free motions on the thigh 
bones, and also where it is connected to the loins; but its 
parts are firmly bound together. So strongly are the 
bones of this living arch bound together, that they can 



'M< OF THE ANATOMY 

not yield, even in time of labour, without extreme vio= 
lence being done. 

The Ilium, a large flat bone, forming the haunch; the 
Ischium, or hip-bone, the lowest part, and that on which 
we sit; the Pubis, to which the genitals are attached, all 
unite in forming the Acetabulum, on either side and with 
the Sacrum and Coxcygis form the whole Pelvis. The 
last described bones being connected with the thigh 
bones, it will be most in order to enter on the bones of 
the lower limbs next. 

The thigh bone called Femur, is strongly bound by a 
large round knob or head to the Pelvis; its body is com- 
posed of very solid bone, it has a neck about an inch and 
a half long, which connects the body of the bone with its 
head, and going off almost at right angles, leaves a pro- 
digious stress on this part, when we carry heavy bodies. 
Its lower end is large and spongy, formed of two knobs 
or processes, called Condyles; these form the upper part 
ef the knee joint, and by their large size give room for 
the insertion of many powerful muscles. 

The leg has two bones called Tibia and Fibula; one 
of which, the Tibia, is connected with the thigh bone in 
forming the knee joint; it also forms the shin. Immedi- 
ately over the knee joint is the Patella, or knee-pan, a 
small flat bone somewhat triangular, and plays over the 
knee joint as a pulley. 

The Fibula is attached to the Tibia a little below the 
knee joint, and on the outside. The Tibia and Fibula 
unite in forming the ankle joint, the former being the 
inner, and the latter the outside ankle. 

The foot is formed of seven bones, two of which it 
may be necessary to name. The Astragalus is con- 
nected with the leg bones in forming the ankle joint. 
The Os Calcis forms the heel, and gives a firm hold to 
the greatest tendon of the body, called Tendino Jlchillis. 
The remaining bones of the foot, which, with the last 
described, composes the Tarsus, and the five metatarsal 
bones, with those of the toes, it would be useless to de- 
scribe; it may be observed, that the great toe has but 
two bones, and all the others have three each. 



OF THE HUMAN BODY. $5 

We are now to return to the upper limbs, and there 
complete our description of the skeleton. The Clavicle, 
on either side, is connected to the Sternum in a manner 
somewhat peculiar; it has no Capsular Ligament, as the 
other joints, and has a small moveable cartilage interpo- 
sed between it and the Sternum, which, like a washer in 
machinery, facilitates motion, and lessens the friction. 
This bone is solid and pretty round, moving freely on 
the Sternum, at its inner end; it is connected with the 
Scapula, or shoulder-blade, by strong ligaments, which 
leave it very little motion. 

The Scapula, or shoulder-blade, is a very complex 
bone, and divided by the anatomist into many parts; it is 
a thin flat bone of considerable size, attached to the ribs, 
&c. by powerful muscles, >vhich allow it free motion. 
At its upper edge there is a considerable projection or 
process, called the Acromion, which is highly important, 
as it prevents the head of the Humerus, or shoulder-bone, 
from slipping upwards. Just below this is the Glenoid 
cavity, a very slight cavity or depression, into which the 
head of the shoulder-bone is received, or perhaps more 
correctly speaking, to which it is attached; for there is 
but a very shallow socket, which leaves this joint more 
subject to dislocation than any joint in the body. 

The Humerus, or upper arm-bone, is a pretty round 
smooth bone, with a large round head, where it is con- 
nected with the shoulder-blade. At its lower end it has 
two prominences, called Condyles, which form the upper 
part of the elbow joint; these, or either of them, may be 
fractured and mistaken for dislocation of the joint, and 
therefore, it requires much caution in managing injuries 
of this joint. 

The forearm is composed of two bones, the Radius 
and Ulna. The Radius is connected to the outer Con- 
dyle of the Humerus, by a round head, which gives to 
the arm its principal rotatory motion; it forms the prin- 
cipal connexion with the Carpus, or bones of the wrist. 

The Ulna forms a large share of the elbow joint, being 
connected with the inner Condyle of the Humerus; and 
with a hook-like elongation, passes some distance round 
4 



26 OF THE ANATOMY 

the arm-bone, forming a hinge-like joint; this process is 
called the Olecranon, and is subject to be fractured. 

The wrist is composed of eight bones, called Carpal 
bones, while the bones of the hand are called Metacapal, 
and are five in number. It is notorious that the finger* 
have each three bones, the thumb has but two. 

Having now completed our description of the bones, 
so far as it can easily be understood without plates, or 
actual dissection, I shall pass on to the Cartilages and 
Ligaments. 



SECTION III. 

Of the Cartilages. 

Cartilage, or gristle, composes the head or knob of 
jointed bones, being smooth and in a great degree insen- 
sible; it is well suited to the purposes of giving free and 
easy motion to the joints, without friction or irritation. 
The whole skeleton is Cartilaginous in the Foetus, or 
forming child; and it is by slow degrees only, that the 
Cartilage is removed by the proper vessels, at the same 
time the bones are forming, by new depositions of bony 
matter: The external ear, and a considerable part of the 
nose, remain Cartilaginous during life. The inner end 
of each true rib, is connected to the Sternum by a Car- 
tilage of considerable length, which leaves a portion of 
the breast without any better defence than this soft Car- 
tilaginous substance; it, however, gives great freedom of 
motion to the ribs; the false ribs are connected to each 
other by Cartilage at their inner ends; the Sternum is 
terminated downwards with Cartilage; the eye lids are 
edged with Cartilage. In short, every union or connex- 
ion between bones throughout the body is formed of Car- 
tilage. It is remarkable of the Cartilage, that while it 
lays down the form of the skeleton, in the Foetus, or 
forming child, it has no agency in forming the Callus, 
which unites fractured bones. When the ossifying pro- 
cess, or forming of bone, is impeded by accidents, in 
a fractured bone, instead of a proper bony matter, Car- 
tilage is formed, and leaves a kind of artificial joint. 



OF THE HUMAN BODY. 87 

Cartilage, in the finished skeleton, has no perceivable 
blood vessels. The Trachea, or windpipe, is formed of 
Cartilaginous rings. 

Up to the twentieth year, the Cartilage, forming the 
two ends of most of the bones, will separate from the 
body of the bone by maceration in water, and is a cu- 
rious coincidence of agreement, between the perfection 
of the body, and that which, I believe, all nations have 
agreed on as the period at which man becomes indepen- 
dent, or in common language, obtains his age; this being 
the twenty -first year, and the first year of the skeleton's 
completion. 

SECTION IV. 

Of the Ligaments. 

The whole skeleton is covered with a membrane^ 
which is called Periosteum, except on the head where 
it has got the name of Pericranium; it is a strong co- 
vering of skin-like substance, and runs from one bone 
to another, throughout the whole body, and by being 
attached to the circumference of the joints, forms a sack, 
called a Capsule which serves the purpose of strongly 
fastening the bones together, and of confining the Syno- 
via, or liquor of the joints; here, it takes the name of 
Ligament. Besides these Capsular Ligaments, formed 
so immediately from the Periosteum, there is many 
other strong ones running in strap-like pieces, in various 
directions, so as to give to the joints great strength; they 
are composed of a matter extremely strong, inelastick, 
and possessing little sensibility. 

section v. 
Of the Muscles. 

We come now to treat of a very important part of the 
animal system, the Muscles or fleshy part of the body; 
in its general appearance it must be familiar to every per- 
son, from its resemblance to that of our domestick ani* 



£8 OF THE ANATOMY 

mals. Each little bundle or portion of flesh is called & 
muscle, and every muscle has its origin and insertion; 
they arise from, and are inserted into the bones through 
the medium of the Periosteum. Many of the most pow- 
erful muscles terminate in Tendons, or sinews, which 
like ropes, or cords, increase the length, and strength of 
the muscle. It was supposed till very lately, that these 
connecting sinews, or Tendons, were mere condensa- 
tions of the muscular fibres; but it is now well under- 
stood that they are distinct in their nature, and possess- 
ed of no power but what is imposed on them by the mus- 
cles. Every muscle is made up of a vast bundle of 
fibres, or thread-like parts; the distribution of these 
fibres alters the moving power of the muscle, some be- 
ing designed for strength, while others are particularly 
suited for quickness of motion, and act with a velocity 
altogether inconceivable. Those having straight long 
fibres, act more slowly, but possess greater strength than 
those which have their fibres running obliquely; the first 
are called rectilineal, and the latter penniform muscles » 

Perhaps nothing in creation is more surprising than 
the muscular power; for a muscle which in the living 
man could raise an immense weight, immediately after 
death would be torn by the force of a few pounds. Au- 
thors still dispute whether there is any inherent power 
residing absolutely in the muscle, or whether they de- 
rive all their power from the nerves. It is of little con- 
sequence where the power resides; it is equally inscru- 
table as a resident of the nerves, as of the muscles; to 
know that it exists may exalt our views to Him who 
formed us, but all disputes referring living principles to 
mechanical agency, serve but to degrade the disputants. 
The red colour of the muscle in man, and many other 
animals, is not a necessary property; we see many ani- 
mals having great activity and strength, whose muscles 
are nearly white. 

The celebrated John Bell, supposes the muscular 
power to be ever the same, and that fatigue is the con- 
sequence of want of the nervous energy, which, rouses 
the dormant power of the muscles into action. Through- 
out the muscular system each one, (or every bundle of 



tfF THE HUMAN BODY. &9 

fibres,) has a sheath or covering, which in many places 
has great strength: to the great muscles of the thigh, in 
particular, it gives much support; this is called the cel- 
lular Membrane, but gets the name of Fascia. where it 
acts as a brace; where it passes over bone, or where Ten- 
dons rub together, it becomes thicker, and takes on the 
office of lubricating and smoothing those parts. 

But while we admire the wondrous power of the mus- 
cles, let us not forget what a high place they hold, in 
giving suitable form and beauty to the human creature. 
Examine the well turned leg and arm, the lips and face, 
or the fingers, with power surpassing wonder; study the 
numberless motions of the body, the neatness and the 
convenience with which such a variety of muscles act 
without hindrance or incommoding each other, and who 
can but truly and emphatically say, this is the work of 
omniscience. 

SECTION VI. 

Of the Muscles within the body. 

Tracing on the muscles, we come to those situated 
within the body; here we discover other wonderful 
powers, by which involuntary motions are effected, de- 
signed for the accomplishment of the circulation of the 
blood, &c. Among these, the Heart holds the first place. 
This muscular organ plays incessantly from the time of 
the formation of the Punctum Saliens, (the first moving 
power in the germ,) to the cessation of life. The ge- 
neral appearance of the heart must be well known; it 
lies somewhat obliquely in the chest, and is principally 
on the left side. 

The Diaphram, or inidrif, is that fleshy partition 
which we see in animals, dividing the chest from the 
Abdomen, or belly. It is the principal agent in the 
business of respiration. Although the ribs in general 
concur by means of the muscles of the chest in respira- 
tion, many cases have been found where the ribs had 
become one entire frame of bone, without the power of 
motion, and yet, respiration went on without any seri- 



30 OF THE ANATOMY 

ous impediment. This muscle seems to partake, in a 
high degree, of the influence which the passions have 
over us: it has led a celebrated naturalist to believe 
this was the centre of the nervous power, but unfortu- 
nately for his notion, he mistook a tendon for a large 
nerve The urinary bladder is a hollow muscle, whose 
office is well known. The stomach, the intestines, the 
arteries, and veins are all furnished with muscular 
coats, or in other words, they are made principally of 
muscular matter. 



SECTION VII. 

Of the Arteries, 

Having given some account of the muscles, I shall 
now endeavour to give some idea of the arteries and 
veins; these, with their functions, will be most easily 
understood, by first giving* a description of the heart. 

The heart is a hollow muscle having four cavities; 
two of which are somewhat superficial, called auricles, 
which are sack-like appendages to this organ; between 
these auricles and the ventricles, there is a valve or flap 
which admits the blood to pass into the heart, but pre- 
vents its return. The ventricles are two cavities with- 
in the heart. From the right ventricle arises an artery 
called the pulmonary artery, which enters into the lungs, 
and branches out like the limbs of a tree, and thus sup- 
plies every part of the lungs with blood. 

From the left ventricle of the heart, arises the great 
artery which sends off the blood to be carried through 
the whole body; it is called the aorta; it passes along 
up the spine, and gives off branches to be distributed 
upon the head and arms; then turning downwards, this 
great arterial trunk lies along the left side of the spine, 
till it reaches the pelvis; here it gives off many branches 
to nourish the fleshy mass about the pelvis; two main 
trunks go to the thighs and legs. Like the branches of 
a tree, the arteries divide, and at each division becomes 
smaller and smaller, till they are so small, as to be im- 
perceptible to the eye. They pass through every mass 



OF THE HUMAN BODY. 31 

of flesh, through every viscus, enter every bone, and 
every solid part of the body. Having conveyed the 
blood, and given life, and warmth, to every part of the 
body, they terminate in the veins. 

The veins, with a reversed course, arise from all the 
mouths or terminations of the arteries, and becoming 
larger and larger, like the collecting rivulet, grow into 
one immense vein, called the vena cava, which termi- 
nates in the right auricle of the heart. The veins are 
more numerous than the arteries, have less strength, and 
are furnished with valves or flaps; the blood moves up- 
wards in most of the veins, and hence the necessity of 
these valves. Many of the veins are superficially situ- 
ated, but the arteries are more securely and deeply sea- 
ted among the muscles. 



SECTION VIII. 

Of the Brain. 

In treating of the brain, I shall speak of the whole 
brainular system, comprehending the brain, usually so 
called, the madulla spinalis, and the nerves. If we have 
seen wonderful power in the muscles, calculated to exalt 
our ideas of the great architect, with how much greater 
reverence and admiration shall we examine that great 
assemblage of matter, which gives sensation, volition, 
and motion to the whole structure. To speak of the 
structure of the brain, wich its appendages, according to 
its anatomical divisions, would be useless; for, such is 
the intricacy of this system, that even years of actual dis- 
section would be necessary for obtaining a complete 
knowledge of all its parts; and when understood, no 
idea can be formed of its functions from its organization; 
all beyond description is mere conjecture. The brain, 
generally so called, is of immense size in the human sub- 
ject, being larger than that of any other animal; it is a 
soft pulpy substance, filling the whole skull, is closely 
enveloped in its circumference, and many of its greater 
divisions, by a very strong membrane, called the dura 
mater; and in its smaller divisions, is lapped in a very 



%% OF THE ANATOMY 

delicate fine membrane, called the pia mater; this last 
is the only partition between some of the greater divi- 
sions; these divisions are called ventricles, but there is 
no cavities in a healthy brain: in dropsy of the head, 
these ventricles are filled with water. 

It is remarkable of the internal structure of the head, 
that there is a considerable number of large veins, called 
sinuses; these run along the dura mater between the 
different lobes of the brain, and contain a great quantity 
of blood; and further, that there is no fat within the head, 
nor cellular membrane, which is to be found every where 
else. It is supposed that fat is of too unstable a nature 
to be admitted into this grand mansion of life and sensa- 
tion. The brain has usually been divided into a few 
prominent parts; the cerebrum, having two lobes, occu- 
pies the fore part of the head; the cerebellum and ma- 
dulla oblongata, the hind part, being the smaller portion. 

Eell considers the madulla spinalis, or spinal marrow, 
and even the nerves, as parts of the brain. In this opi- 
nion I concur. The great mass of the brain is composed 
of two parts, called its cortical and madullary substance; 
from the madullary part, the nerves go off; they are small 
white cords; each one is enveloped like the brain, in its 
membranes, and are accompanied with blood vessels in 
all their course. 

The nerves originating from the head, have usually 
been reckoned ten pairs, but one pair of these arise from 
the ntadulla spinalis, mounts into the head, and passes 
out thence, as though it originated there. From the mu- 
dulla spinalis go off, generally, thirty pairs, one pair be- 
tween each joint of the spine; these give nerves to the 
arms and legs, and are connected in many places with 
those from the head, and assist in supplying the viscera. 

There is a pretty general connexion among the nerves; 
they form nervous centres, which are little knobs called 
ganglions, and also net-like collections called plexus. 
All the nerves of particular senses, as the olfactory for 
smelling, the optick for vision, the auditory for hearing, 
the gustatory for tasting, and the cutaneous for the touch, 
terminate in a soft pulpy matter. It is highly probable, 
the active matter throughout the whole nervous system* 



OF THE HUMAN BODY. S3 

is similar to that of the brain. On this foundation, we 
view the brain as occupying not only the head, but as 
being distributed over the whole living system, and giv- 
ing life and activity to all. When particular nerves are 
destroyed, the parts which they supply lose all power, 
and soon die. It is a curious fact, that the nerves of 
part of the body, may lose the power of willing, or vo- 
luntary motion, and yet retain the power of carrying on 
the circulation, and maintaining life, as we see in palsy. 



SECTION IX. 

Of the Circulation. 

The blood from the whole system being collected into 
the great vena cava, enters the right auricle of the heart; 
the peculiar and agreeable stimulus of the blood, causes 
the auricle, or sack-like appendage of the heart, to di- 
late and receive a gush of blood, till being filled, it sud- 
denly resists or contracts, so as to force the contained 
blood forwards into the right ventricle of the heart; 
the ventricle in like manner dilates to receive a charge 
of blood, and then contracts, and propels the blood 
into the jpulmonary artery, which proceeds from the 
right ventricle, and enters into the lungs. The auri- 
cles and ventricles are furnished with valves, or flaps,, 
which prevent the blood from returning. The blood 
having passed through the lungs in the ramifications of 
the jpulmonary artery, passes from the numberless arte- 
rial extremities into the pulmonary veins, which collect- 
ing into larger and larger veins, unite in one great vein; 
this vein enters the left auricle of the heart, and passes 
on the blood into the left ventricle, and from thence it 
is thrown into the great aorta; from thence it is carried 
throughout the whole body. We may observe here, 
that there is a double circulation of the blood; first 
through one side of the heart and the lungs, and then 
through the other side of the heart, and the general sys- 
tem. The blood, in traversing the lungs, undergoes 
some important change. It parts with carbon, in a form 
unfriendly to health; and receives from the air taken ill- 
s' 



34* * OF THE ANATOMY 

to the lungs a portion of oxygen. This double process 
of rejecting the parts unfit for the wants of the system, 
and receiving oxygen, without which we cannot exist, is 
a phenomenon still somewhat clouded with uncertainty, 
and of the highest moment to the animal economy. The 
blood, by the action of the lungs, becomes of a brighter 
red; and here something is imparted to the brain and 
nerves, without which we cannot exist an instant. This 
appears to be a modification of oxygen. 

It has been supposed that the reception of oxygen 
into the blood, through the lungs, was the cause of ani- 
mal heat, but this is at best a very doubtful matter, if 
it be not really refuted. It seems more likely that ani- 
mal heat is caused by the chymical operations within the 
body; fluids, in becoming solids, invariably elicit heat. 
It is probable, that the perpetual renewal of the solids 
from the fluids, set free a portion of calorick, or matter 
of heat; and thus, instead of a centre of heat in the lungs, 
the very operation by which the solids are every where 
formed, gives a degree or quantity of heat, suited to the 
particular well-being of each part. The blood having 
entered into the left ventricle of the heart, furnished 
with this pabulum or food for the brain, nerves, and the 
whole system of systems, passes on with an amazing 
velocity through the arteries of the whole body. The 
arteries terminate in the veins, and the veins collect the 
blood which is no longer fit for the purposes of life, ,and 
convey it back again to the heart. 

In its course the blood not only gives nourishment in 
the common acceptation of the word, but, with the aid of 
the arteries, dissolves down and carries away worn out 
parts, and leaves new animalized matter, precisely suit- 
ed to the parts over which it passes; with the glands it 
leaves juices, some of which are nutricious, some dissol- 
vent, some lubricating, and others excrementitious; and 
to the bone it gives bone, to the flesh it gives flesh, and 
so of all the members of the body. But highest in the 
scale of life is that subtile something imparted to the 
brainular system; the brain and nerves, like all other 
parts, owe their life and power, and perpetual renewal, 
to the blood. 



OF THE HUMAN BODY. 35 

The blood in its course through the body, like the 
watch of an army, exchanging sentinel for sentinel, ex- 
changes particle for particle; leaving the healthy and vi- 
gorous particle or soldier on his post, while the exhaus- 
ted or languishing one is led away for another occasion, 
or dismissed the service. 

From about the extremities of the arteries, but not by 
anastomosis, or immediate union of mouth to mouth, ari- 
ses a set of fine thin vessels, called lymphaticks; these, 
like the veins, collect their fluid from small to larger bran- 
ches, and terminate in the lacteals, in the large veins, 
and thoracick duct, which lies in the chest. 



section x. 

Of the Blood, 

The blood, is composed of three parts, called the eras* 
mmentum, serum, and red globules. The serum is that 
watery part which generally rises to the top when blood 
is suffered to cool in a vessel; the crassamentum is blen- 
ded with the red globules; the quantity or proportion of 
each of those component parts of the blood vary consid- 
erably: we see it sometimes composed in great part of 
serum. It also differs much in appearance in different 
parts of the healthy body, being florid in the arteries, 
purple in the veins, and almost black in the liver, and 
in the great vein connected with the right auricle of the 
heart. 

Chymic^lly considered, the blood is a compound of 
many ingredients; it has a portion of iron; but no ad- 
vantage could be expected from inquiring into its con- 
stituent elements in this sketch; it is only by torturing 
it we can separate its parts, and it is highly probable 
that, by our clumsy experiments, we produce new com- 
binations. If the fragrant flower can drink up simple 
water, (and this we know to be a fact,) and give out all 
its rich perfume, how little hope is there that we can trace 
the elements of even the most simple body in nature! 



36 OF THE ANATOMY 

SECTION XI. 

Of the Glands. 

These exist in every part of the body, and are com- 
posed of an assemblage of vessels; an artery, a vein, and 
lymphatick, with their covering of cellular membrane, 
enters into the formation of every gland. They differ 
much in size, and in their functions; the salivary glands, 
situated about the neck and mouth, separate the saliva 
or spittle from the blood; the mammce, or breasts of the 
female, separate the milk; the kidneys separate the urine, 
and so on. Every joint and every cavity is constantly 
moistened either with a fluid, or thin halitus. Thus the 
glands, constantly washed by the blood, abstract each 
one something peculiar from it, or impart to it some new 
properties, or lead from the mass excrementitious mat- 
ters. That function by which parts are elected for the 
use of the system, is called secretion; that by which they 
are rejected as useless or unfriendly, is called excretion. 
Hence comes secretory, and excretory vessels, which are 
probably nothing but capilliary terminations of the arte- 
ries and lymjmaticks. 

SECTION XII. 

Of the Viscera. 

Having, in the preceding pages, given some account 
of all the parts which are blended more particularly 
throughout the whole system, I come now to treat of 
parts which, although equally necessary for the general 
welfare, nevertheless, occupy but a fixed place, and there 
seemingly await the agents by which they are brought 
into action. These are all the organs of the chest, ab- 
domen, and pelvis, with their membranes and other ap- 
pendages. In describing those parts, I have thought 
best to commence with what is usually called the pvimm 
vim, or first passages. 

The masticated food mixed with a quantity of saliva, 
or spittle, proportioned to the chewing it has undergone, 



OF THE HUMAN BODY. 37 

passes ever the windpipe, enters the throat through the 
pharynx into the gullet or oesophagus, thence into the 
stomach. Being lodged in the stomach, digestion com- 
mences; such is the organization of the stomach, that its 
secretory vessels pour out a juice, called the gastrick li- 
quor; this fluid has the power of dissolving down the 
food into a thin or pulpy mass, which by some incom- 
prehensible action in the stomach, is raised up and pas- 
sed out at the pylorus or entrance into the gut, for the 
orifice is not on the lower part of the stomach, but situ- 
ated near its upper side: the food now passes down the 
intestinal canal, which runs in a tortuous direction through 
the belly, and is five or six times the length of the whole 
body. 

The intestines are divided by the anatomist into small 
and large; the smaller commence at the stomach, and 
are, first, the duodenum, jejunum, and ilium; then com- 
mences the larger, first, the colon; this gut is long and 
has the second attached to its side, called cozcum, which 
is a mere blind small tube-like appendage; and lastly, 
the rectum; the termination of the rectum called anus, 
is formed of a sphincter muscle, which, by surrounding 
the orifice, commands the passage. Those divisions of 
the intestines are in some measure arbitrary, but are ne- 
cessary for the anatomist. The intestines are provided 
with glands, or absorbent vessels, which take up the 
nutritious thin part of the food, while the grosser parts 
are carried through the intestines, by means of a con- 
stant vermicular motion called the peristalticjc motion. 
The aliment having passed into the intestines, mixes 
with the bile and pancreatick juice: the pancreas, or 
sweet bread, is a large gland under the upper part of the 
liver. From the intestines arise a set of vessels called 
the lacteals, whose office it is to take up the nutritious 
part of the aliment called chyle; these vessels, uniting 
into larger branches, collect the chyle into one duct or 
tube, and convey it up through the chest, and then pass 
it into the veins; these lacteal vessels run on the me- 
sentery, or that strong skin-like substance which ties 
down the intestines in all their turnings, as we see in 
quadrupeds. 



38 OF THE ANATOMY 

The chyle being mixed with the blood, is conveyed 
through the heart, thence through the lungs; here, it is 
exposed to the atmospherick air, and becomes somewhat 
annualized, passes through the heart again, and thence 
into the general circulation. The intestines are also fur- 
nished with vessels, which constantly pour into their 
cavity a mucous substance, for moistening and sheath- 
ing their nervous coat. Hence comes that constant col- 
lection of feces, which must be notorious to every one, 
for by giving purges daily, as well as in some wasting 
diseases, we see copious discbarges from the bowels 
even where no food is taken. It is a curious fact that 
where the intestines were wounded and sewed up with 
thread, knotted on the outside, these knots, with the 
whole thread, has been carried into the intestinal canal, 
and carried off, while at the same time the parts were 
healed. 

The liver is composed in great measure of a tissue of 
vessels: and through it, there is an extensive circulation 
of venous blood: it occupies a large portion of the abdo- 
men, filling the right side, and lapping over the stomach; 
its office is to secrete the bile from the blood; the bile is 
an indispensable ingredient in digestion, and is convey- 
ed from the liver into the duodenum, or first intestine. 
As an appendage or reservoir to the liver Ave find a gall- 
bladder, the duct or passage from which runs into that 
from the liver, and it is only through this duct the gall- 
bladder is filled, but for what precise purpose we know 
not. 

On the opposite, or left side of the belly, and in con- 
tact with the stomach, lies the spleen; the office of which 
is not known, but most probably it is concerned in the 
business of digestion: this organ suffers particularly in 
long continued agues; and has given rise to the name of 
a very unpleasant disease, the spleen, or hypochondria- 
sis. The kidneys lie in the back part of the abdomen, 
at the upper part of the loins, the one in some mea- 
sure under the liver, and the other under the spleen; 
they separate the urine from the blood; from their cavi- 
ties, into which the urine is secreted, arise two tubes 
called ureters; they enter the bladder at its neck, in 



OF THE HUM AX BODTE. 39 

such a maimer that nothing can pass out at these open- 
ings; from the bladder the urine is occasionally forced 
by the abdominal muscles, assisted by its own muscular 
fibres. The passage from the bladder outwards is cal- 
led the urethra. 

The whole abdomen is lined with a sensible mem- 
brane called the peritoneum; and over the fore part is 
spread a net-like web. generally loaded with fat. called 
the omentum. These, then, complete the parts within 
the abdomen and pelvis, exceptiug the organs of gene- 
ration, which will be spoken of occasionally, or found 
in the glossary at the end of this book. 

The chest or thorax, besides the heart, the great 
blood vessels, and ihoracick duct, or great chyle vessel, 
contains the pleura, mediastinum, pericardium, and 
lungs. The whole chest is lined with a sensible mem- 
brane which is called pleura, the seat of common pleu- 
risy. The breast in the human subject, has a double 
membranous partition, which rims lengthwise, and is 
called mediastinum: it divides the two great lobes, or 
portions of the lungs. The heart is inclosed in a strong 
purse-like sack, called pericardium. 

The lungs are formed of two great lobes, and these 
again are divided into several smaller lobules: besides 
the blood vessels, we find in the lungs a set of vessels 
called bronchice. these, from very small beginnings^ 
unite into larger trunks, till they end upwards in one 
great trunk, called the trachea, or windpipe, which ends 
in the back part of the mouth, in a small opening called 
glottis, and this again is covered by a small lid. or flap^ 
called the epiglottis; over this opening all the liquids 
and food passes, and yet. such is its wonderful struc- 
ture and power, that although open at every inspiration 
and expiration of the breath, it is but seldom any acci- 
dent occurs. 

SECTIOX XIII. 

Of the necessary distinction of Parts. 

It may not be amiss to give a short account of the 
names by which medical writers designate particular 



40 



OF THE ANATOMY' 



parts, by a reference to certain outward regions. The 
hollow on the middle of the breast is called the scrobi- 
cuius cordis; the middle of the abdomen, or belly, above 
and below the navel, about three fingers breadth, is 
called the umbilical region; the middle part of this, epi- 
gastrium; under the cartilages of the lower ribs, hypo- 
chondrium; and from the umbilical region, down to the 
pubis, hypogastrium. 

In the mouth the following parts are situated; the 
gums are too familiar to require description: Fauces, the 
top of the throat; palat, the roof of the mouth; uvula, a 
small fleshy process hanging from the hind part of the 
mouth, and usually called the palate of the mouth. This 
is subject to inflammation, in which case the muscles of 
the throat, called pharyngeal, are excited into action, 
and as it were, suck down this part, as they will all sub- 
stances with which they come in contact. This, so far 
as I recollect, is a new idea, and I am well convinced 
it is correct. And hence it follows, that to talk of ele- 
vating this part while the swelling continues, is ill 
founded; the only means for removing this unpleasant 
involuntary attempt at swallowing the uvula, is frequent 
gargling with emollient articles, as milk antl water, or 
thin mucilage, when it is accompanied with inflamma- 
tion; and as soon as the inflammation abates, or if the 
disorder arises from relaxation, gargle with some spirit, 
or with a strong decoction of oak bark, with a little 
alum. 

A strong faith in the whimsical remedy of raising the 
palate by taking up forcibly a lock of hair, reminds one 
of the ridiculous ideas which have so long maintained 
their credit, of bleeding in the hands and feet, in the 
head, stomach, and uterine veins, &c. when it is as well 
known as any other fact upon earth, that all the veins 
communicate immediately with the heart. 

I have more than once seen the busy and would-be- 
wise women bandying about the terrible tale, that Miss 

had been bled, at her own desire, in the uterine 

vein for miscarriage. Oh! ignorance, where is thy bot- 
tom? Oh! envy, where is thy bounds? Immeasurable 
as original sin, from which they sprung, naught can mea- 



OF THE HUMAN BODY. 41 

sure or restrain these automaton monsters, save religion 
and truth; for truth is wisdom in her loveliest garb. 

I have now described all the parts of the btrdy which 
I consider most interesting to be known: all those re- 
maining, or anatomical terms, will be found either in 
speaking of the organs of sense, on disease of the vari- 
ous parts of the body, or in the glossary which will be 
formed at the end of this work. I therefore conclude 
the subject of anatomy with a short 

RECAPITULATION. 

It will occur to those possessing a knowledge of ana- 
tomy, that some of the organs have been omitted; among 
these is the eye, for instance; but a general outline hav- 
ing been given, the reader must in some measure be pre- 
pared to understand their structure and use, so far as 
may be necessary for those for whom this work is de- 
signed, when I come to treat of the senses, or of disease. 

1st. I spoke of the skin as a general envelope or co- 
vering for the body, as being furnished with nerves for 
the sense of touch; and further, as sympathizing through 
the medium of the nerves and vascular system with the 
whole animal economy; and I may add, that from the 
skin arise the nails and hair. 

2. Of the bones, as giving form and support to the 
body, and having their blood-vessels and nerves, like 
every other part: and I may add here, that they are in 
good measure composed of lime or earthy matter; and 
that the solid bones are hollow and filled with marrow, 
having little or no sensation; the use of which we do not 
understand. 

3. Of the cartilage, as giving form, &c. to the joints, 
and connecting some of the bones, being what in com- 
mon language is called gristle. 

4. Of the ligaments, being formed out of the peiHos- 
teum, and securing the joints firmly together; and of the 
periosteum covering the whole bony surface. 

5. Of the muscles, as performing the motion of the 
body; being bundles of fleshy threads; giving shape to 
the body^ and possessing a wonderful living power, 

6 



4& OF THE ANATOMY 

Which decreases amazingly after death; for the muscU 
which would have raised a heavy load, would not bear 
the weight of a few pounds when dead. 

6. Of the tendons or sinews, as connecting the ends 
of some of the muscles to the periosteum and bone. 

7- Of muscular organs within the body; and first, the 
heart, to circulate the blood, undergoing incessantly, du- 
ring life, dilation and contraction of its cavities; and 
thereby sending the blood through the lungs, and then 
through the whole body. 

8. Of the diaphram, being a muscle principally in- 
strumental in respiration, and as being under the influ- 
ence of the passions. 

9. Of the arteries, as arising from the heart, and car- 
rying the blood throughout the whole system, and by 
means of the blood constantly renewing every part and 
taking away the old. 

10. Of the veins, as collecting the blood from the ex- 
tremities of the arteries, and returning it to the heart; 
and of the lymphaticks, as collecting a thin fluid through- 
out the body, and conveying it into the veins. 

11. Of the brain, being the source of sensation, voli- 
tion, and motion; as going in a large column down the 
spine, and further, as being probably distributed through 
the system generally. 

IS. Of the circulation, by which the blood is brought 
into contact with every particle of living matter, and im- 
parting life, even to the brain and nerves, and further, 
as giving out animal heat 

13. Of the glands, as secreting from the blood the va- 
rious juices of the body; being associated in the busi- 
ness of filling every internal surface with moisture, &c. 

14. Of the primce vice, or first passages, being the 
stomach and intestines, whose office it is to digest the 
food. 

15. Of the lacteals, as taking up the nutritious part 
of the food, called chyle, and conveying it into the circu- 
lating blood. 

16. Of the liver, secreting the bile, and pouring it 
into the intestines below the stomach; and of the bile 
being an indispensable ingredient in digestion; and of 



OF THE HUMAN BODY. 43 

a pancreatick juice being also poured into the first in- 
testine. 

17. Of the spleen, the offices of which are unknown. 

18. Of the kidneys, secreting the urine and carrying 
it into the bladder, through the ureters. 

19. Of the peritoneum, as lining the whole abdomen 
and pelvis, and of the omentum covering the bowels. 

20. Of the pleura lining the breast, and being the seat 
of pleurisy. 

21. Of the mediastinum, as dividing the chest length- 
wise, and also running between the lobes of the lungs. 

22. Of the pericardium, like a purse enclosing the 
heart in a strong sack. 

23. Of the lungs, being composed of two lobes; ha- 
ving bronchial vessels, which rise up and collect into one 
large trunk, called trachea or windpipe, &c. 

Having gone thus far, it only remains to speak of a 
few parts unnoticed, this will be done when treating of 
their diseases, or of the organs of sense; or will be suf- 
ficiently explained in the glossary, at the end of this 
book. 



0F THE SENSES, 

SECTION f. 

Of the Sense of Touch. 

THIS sense exists throughout the whole skin, but in 
greatest perfection in the fingers; the organs by which 
it operates are pulpy terminations of nerves, which ri- 
sing up in little points, are called papillce. It may be 
remarked of the sense of touch, that while the fingers 
possess the most exquisite perceptions, they can still 
bear a greater degree of temperature without pain, than 
many other parts, particularly the cheeks. 

The sense of touch seems to exist in all parts fur- 
nished with a skin-like surface, and although the exter- 
nal skin is more especially endowed with this property, 
we are well assured that, the tongue, mouth, throat, sto- 
mach, intestines, &c. possess it in a high degree. Pro- 
bably, a large share of the perfect state of this sense in 
the skin, is owing to its being more particularly exerci- 
sed in that way. 

To this sense we may refer the pleasurable sensations 
which arise from taking food into the stomach; and also 
those from taking air into the lungs. These, from long 
inattention, we are not very sensible of, but who has not 
felt pleasurable sensations in the stomach, from taking 
in food after fasting some time? or who has not felt plea- 
sure, and a general invigoration, from inhaling the mild 
breezes of salubrious air into the lungs? 

And may we not carry our views a little further, and 
inquire whether the brain too, is not endowed with this 
sense, in its common acceptation? When we inhale ni- 
trous oxyd gas, we apparently operate on the brain, by 
the sense of touch, and as it were tickle the mistress of 
the sensorium out of her senses. Like the tickling on 



OF THE SENSES. 45 

the external surface, producing a strange mixture of 
pleasure, pain, and violent action, this tickling of the 
brain, by means of this gas, produces violent, irregular, 
and exhausting operations of the mind. If then, this 
sense is so generally diffused through the system, and so 
intimately connected with the brainular system, with how 
much care ought we to guard the organs by which it 
operates, from filth. Let every one keep in view, that 
if he daub his skin with filth, or fill his stomach with 
brandy, or inhales noxious air; these all, are in imme- 
diate contact with the brain. 

Hence it is well said, men steep their senses in wine. 
There is, however, this difference between filth applied 
to the skin and lungs, and that arising from the potions 
of Bacchus, that the latter is the most easily avoided, 
and generally speaking, begets every kind of filth of 
body and mind, till its wretched victims, sometimes 
drag out a miserable existence, being a mere living 
dunghill. Of such it may be said, 

Poison not only lurks in every vein, 

But filth too, at length, crawls among the brain; 

Teazing, and increasing from iil to bad; 

Until past endurance, the man runs mad: 

Or, if by constitution good and strong, 

He is enabled to pursue the wrong; 

Why not see the fate of those gone before, 

And on the road to ruin find one more. 

Or, how on such dire warning can he tread, 

While wife, or children, tears in rivers shed. 

SECTION II. 

Of the Sense of Taste. 

The organs of taste are situated on the tongue, and 
like those belonging to the touch, are little nervous pa- 
pillce, or points; they are only to be found on the edges 
and end of the tongue. The upper side, and middle of 
the tongue being scabrous, or rough, is only suited for 
moving the food through the mouth. The use, and ap- 
pearance of the tongue is so well known, that I have 
only to observe, that it is covered with a true skin, 
something like the skin of the body. 



46 OF THE SENSES. 

The taste of man is so much abused and perverted in 
his infancy, that we can discover little or no relation be- 
tween the aliment and the taste. While the English- 
man delights in his beef and pudding, and the French- 
man prefers his light savoury articles, there are people 
found, who drink down rancid train oil with rapturous 
delight. 

The people of the United States have no national 
taste unless it be for coffee. 

The experience of ages has shown, that man may 
vary his food greatly; but the same experience teaches 
us, that to be healthy, we must be temperate; or, in other 
words, we must not multiply our dishes too much, or 
disease is the invariable forfeiture. The taste must be 
considered the lowest sense belonging to man; it, how- 
ever, is oue which tends to equalise: from the king to 
the beggar, disease will follow intemperance in eating 
or drinking. 

We are well assured, that many great men who had 
scarcely exercised this sense at all, lived on the most sim- 
ple diet to a good old age. 

To brutes, pretty generally, it is a tolerable guide for 
selecting their food; not so with man; for whosoever sets 
about to whet up this sense for enjoyment in gormandi- 
zing, obtains no more pleasure than the brute enjoys dai- 
ly, without instruction and without pains; and he seldom 
fails to pay "dearly, very dearly, for the whistle." 

It may be said, that while the taste stupidly licks up 
the poison, perhaps rolled in honey, the noble eye points 
to danger. Has your enemy the advantage of the eye, 
in position, the touch, roused by violence offered, never 
deceives in announcing danger; and are you surrounded 
by darkness, the sense of hearing sounds the alarm; but 
the taste, like the insidious serpent, beguiles its votaries. 
Then, let me admonish you, beware; for, # like a turbu- 
lent and unruly fellow, it must be kept low. It is a kinq% 
sweet servant, hut makes a vicious master. 



«F THE SENSES. 47 

SECTION III. 

Of the Sense of Smelling. 

The immediate organ of smell is a pulpy expansion 
of the olfactory nerves on the fine membrane covering 
the ethmoid bone, called the sneiderian membrane. 
How this nervous expansion takes up sensation and car- 
ries it to the brain, we can form no conception; but we 
know that all bodies which we can smell, emit effluvia, or 
very fine particles, which, by coming in contact with, 
the pulpy nerves, give impressions according to their 
nature. 

The pleasure arising from the smelling of many arti- 
cles is considerable; but much is owing to habit, some 
liking best what others cannot endure: and further, it 
may be said, most perfumery is unwholesome when much 
indulged in. 

Through the organs of smell we can often operate 
beneficially on persons affected with hysterick fits, or in 
some cases of fainting, by means of pungent articles, as 
burnt feathers, volatile spirit of hartshorn, &c, when all 
the other senses are, as it were, locked up* 

By applying suitable articles to the nose, we rouse the 
slumbering energies of the system, and often enable the 
person to recover recollection and muscular action, with- 
out the use of any other means. 

It may be said of this sense, that we are less depen- 
dant on it than any other, some persons having lost the 
power of smelling, without experiencing much inconve- 
nience. 

SECTION IV. 

Of the Sense of Hearing, 

The appearance of the external ear is well known; we 
may however observe, that it owes its form to cartilage; 
that it is admirably contrived for the purpose of collec- 
ting sounds; and its internal parts are defended from 
accidents, in good measure, by a secretion of wax, and 



48 OF THE SENSES. 

by hair within, which prevent dust or insects from en- 
tering. 

From the internal ear there is a passage into the mouth, 
called the eustachian tube, which is subservient to com- 
plete hearing. 

The auditory nerves are deeply seated, and are acted 
on by the vibration, or undulatory motions of the air, for 
sound cannot pass through the exhausted vessel of an 
airpump. 

Such is the intricacy, multiplicity of parts, and won- 
derful contrivance in the structure of the human ear, that 
nothing in the body is less understood; nothing more 
beautiful; nothing more strongly manifesting the wisdom 
of the omniscient architect. 

We speak of the drum of the ear, and of its hammer, 
&c; from which men were once contented to believe, 
these parts by their mere mechanical contrivance, per- 
formed the act of hearing; but these speculations are now 
at rest, for instances have been found, where not only 
the drum and hammer, but several of the bones, have 
come away without very much impairing the hearing. 

That all the parts are necessary for the most perfect 
enjoyment of this sense, is certain; but for the common 
purposes of life, this sense may be quite good, and suf- 
ficient, after all those parts, which were once supposed 
to be the exclusive organs of hearing, have come away, 
from suppurations. 

Again, the ear may be perfect in all its parts, and the 
nervous power still wanting, by which the impression 
could be carried to the sensorium, and this is a hopeless 
source of deafness, unless it be symptomatick of some 
other disease. 

None of the senses are more liable to morbid acute- 
ness; so high is the sensibility at times in the nerves, 
that common sounds become painful, and false sounds 
arise within the ear, resembling the noise of boiling wa- 
ter, the tinkling of bells, &c. 

The healthy ear, perfectly formed, and suitably ex- 
ercised, is a source of the most sublime enjoyment. All 
nations adopt musick in their forms of worship. The 
dulcet sounds spread like seraphick wings, and as it 



OF THE SENSES. 49 

were, abstract the soul from the body, to soar aloft; and 
tower there! till the sound dying away, the mind falls 
again, gently, like the mild dews of heaven. 

Who can enjoy the rapturous melody arising from 
harmonious sounds, without catching a glimpse of hea- 
ven? 

section v. 

Of th e Se n se of Seeing. 

The organs of this sense, are beautifully formed of a 
variety of parts, many of which it would be useless to 
mention here. Some of its most conspicuous parts may 
be enumerated with advantage; indeed it is absolutely 
necessary for every person, to have some knowledge of 
this important organ, that they may be enabled to under- 
stand the oculist, when speaking of its diseases. The 
rational creature who does not acquire some knowledge 
of himself, is remiss in duty to his Creator, for it is by 
contemplating the works of nature, we discover more 
and more, the wisdom and goodness of the Supreme. 

The eye, considered as a whole, is a hollow globe, 
filled with fluids. The substance which forms this globe, 
is of a membranous structure, formed of different layers, 
called coats. The external coat is a strong whitish sub- 
stance, and surrounds the whole eye, (except a small 
part in front;) it is called the sclerotick coat. It termi- 
nates in a circular opening before, and into this opening 
there is a circular transparent coat inserted, called the 
cornea; this resembles the chrystal set in a watch. Over 
the sclerotick coat is spread a thin coat, containing a 
great number of veins, which are apt to become very 
full and red when the eye isr diseased. It may be 
dissected away in part, without injury to the eye, when 
much inflammed. 

From the inner side of the sclerotick coat, near the 
termination of the cornea, goes off a partition, which di- 
vides the hollow globe into two chambers, called the an- 
terior and posterior chambers. This partition is called 
the iris, and is that part which gives colour to the eye; 

7 



50 OP THE SENSES. 

as the blue, hazle, &c; it is perforated in the middle 
with a round hole, called the pupil. 

Such is the wonderful structure, and power of the iris. 
that it opens, or dilates the pupil, so as to regulate the 
quantity of light which strikes the eye; in a dark place 
it opens the pupil to a great size, in a strong light it 
contracts it to a mere point. 

Immediately behind the iris, lies a small body, some- 
what like the glass of a spectacle, called the chrystaline 
lens; this is the seat of cataract. This chrystaline lens, 
the water in the anteriour chamber, and the jelly-like 
substance, filling the greater part of the eye, have got 
the very improper names of humours of the eye, and are 
known by the name of aquaous, chrystaline, and vitri- 
ous humours. 

Behind the vitrious humour, and on the inner side of 
the bottom of the eye, is a pulpy expansion of the op- 
tick nerve, called the retina. How the light operates 
on the nerve, and causes it to convey sensation to the 
sensorium, is altogether beyond our reach. 

I shall now endeavour to explain how the light ope- 
rates to impress the image of objects on the retina. 
Light moves only in rays, or thread-like lines, and 
these lines or rays, always retain a course perfectly 
straight, from point to point. When these rays pass 
from a rare, to a denser body, they form an angle strik- 
ing inward, towards the centre; when they pass from a 
dense, to a rarer body, they diverge, or strike outward, 
or from the centre. 

Again, the rays of light are influenced by the surface 
of bodies; opaque substances, reflecting the rays in va- 
rious directions, while they pass through transparent 
ones, and are altered in their course, according to the 
shape of the surfaces, at which they enter, and pass out. 

If the transparent body be of regular shape, as a spec- 
tacle glass for instance, the rays striking on, and pas- 
sing out of a convex surface, the rays are thrown toge- 
ther, and form a point called a focus, and this focus will 
be nearer the glass in proportion to its convexity. 

Now when the rays of light are reflected from an ob- 
ject, and strike on the eye, the cornea being convex^, 



OF THE SENSES. 51 

?he water being denser than the air, and the chrystaline 
lens and vitrions humours still more dense; the rays of 
light are brought to a focus, on the nerve at the bottom 
of the eye, and here gives the image of the object before 
us. 

If the eye be too flat, or its humours too thin, the 
rays of light will not be brought to & focus, but strike the 
retina scattered, in a circle, which gives but a very im- 
perfect knowledge of the object that we wish to see. 

This defect may be remedied by common convex spec- 
tacle glasses, which by bringing the rays sooner to & fo- 
cus, enables the long sighted person to view the object 
nearer to the eye; and this we see daily in the aged 
using spectacles. 

There are persons whose eyes are too convex, and 
therefore, they require concave glasses; these by spread- 
ing the rays of light before they enter the eye, extend 
the focus on to the retina, and gives the image of ob- 
jects, which with the naked eye, were not discernable. 

The importance of concave glasses to near sighted 
persons, may be conceived of, when we see the spy- 
glass bringing objects into view, which the naked eye 
could not discern at all. 

The importance of vision is such, that every one must 
be conscious how vastly he is indebted to it for the en- 
joyments of life. By this sense, we survey the works 
of nature immediately around us, and with the aid of op- 
tical instruments, reach in some measure the immensity 
of other worlds — the twinkling stars, centres of other 
systems — the exhaustless sun — the mighty globes within 
the solar system — the placid moon, within our orbit — 
these lead us to believe, indeed, that, "after millions 
of ages have revolved, the great Father of the universe 
will become more and more incomprehensible." And 
well may we say, "the human mind sinks beneath the 
weight of the infinite object of its future contemplations 
and of its own sublime and happy destiny." 



5% OF THE SENSES. 

SECTION VI. 

Of the Senses in General, 

Under this head I shall give a short recapitulation, 
and conclude with a few inferences. The organs of 
touch are the terminations of nerves in the skin, and 
seem to exist in all the surfaces of internal parts. 

The tongue is furnished with the organs of taste, 
which also are nervous papillm. The people of the pre- 
sent age abuse this sense in particular. 

The smelling power resides in the pulpy expansion 
of the olfactory nerves, and though subservient to man's 
comfort, is of less moment than any other sense. 

The hearing is effected through intricate organs, is 
closely allied with religion; and a source of high enjoy- 
ment. 

The sight is, seemingly, of the most indispensable na- 
ture to man, a source of his greatest enjoyments; its or- 
gan the eye, better understood than the other organs of 
sense. 

But after all the wonderful powers, and beautiful 
symmetry, which are found in the living system, we are 
humbled with the fact, that they are but animal in their 
nature: and we are met here by a still more humiliating 
fact; so totally are the powers of body and mind perver- 
ted and abused, that man, comparatively, is often below 
the quadruped of our farms. 

But revelation opens to our view powers imperish- 
able; when the nervous power shall die and pass away, 
the immortal mind shall rise superiour to death, and 
abide the decrees of the righteous Judge. That the 
mind and body are mutually dependant here, is certain; 
but I fear we too often forget the great distinction. 

Dare I adopt a new word, I should speak of mind as 
the living innervous principle, while I should refer all 
animal actions to a nervous principle, and according to 
common phraseology, an alliance offensive and defen 
sive exists between them. 



OF THE CAUSE OF ANIMAL LIFE. 53 

SECTION VII. 

Of the Cause of Animal Life. 

I have thought proper to enter next on the cause of 
animal life. Here 1 am conscious of a knotty subject, 
but, however little we can understand, or explain the 
living principle, in the present unsettled and imperfect 
state of physiology, we are enabled, by examining into 
some of its laws, to discover useful truths. 

When we examine the body soon after death, we fre- 
quently find every part to appearance sound, but the 
spirit of life is fled, and with it, sensation and thought. 
If our examination is made pretty soon after death, we 
discover a power of motion in the muscles, and by means 
of galvanism, can throw them into convulsions. 

Hence comes a natural inference, that life is continued 
by the impressions of stimuli on the living principle. 
Of this principle, we can form no distinct conceptions, 
but its operations are evident; it is the hinge on which 
both health and disease turn; and it is by accommoda- 
ting stimuli to this principle, we preserve our health, or 
remove disease. It has been named, most generally, 
excitability. 

Health consists in an equal distribution of this excita- 
ble principle throughout the whole system. An ani- 
mal body wanting this excitability, has no powers, and 
soon undergoes decomposition. 

On this excitability various stimuli act to support life. 
Thus light stimulates the eye, sound stimulates the ear; 
the air stimulates the lungs, and the food stimulates the 
stomach; while the blood stimulates the heart, the brain, 
nerves, and in short, every part having excitability. I 
have said, health consists in an equal distribution of the 
excitability; now, as this excitability is exhausted by 
stimuli, it follows, that if we over stimulate any one part, 
we produce derangement, and if long continued, or too 
forcible, disease follows. 

When we operate on the excitability, by stimuli, we 
produce excitement, and a due balance between this ex- 
citement and the excitability, constitutes health. 



;?4 OF THE CAUSE OF ANIMAL LIFE. 

Tf we take a large quantity of any article into the sto- 
mach, it may stimulate by its quantity, although mild in 
its nature; or if we take ardent spirit, or other very 
strong articles which stimulate by their quality, we ex- 
haust the excitability; if they are carried too far, indiges- 
tion, or disease follows. If we exercise moderately, we 
raise the circulation and produce a moderate excitement, 
and thereby expend the excitability, slowly and equally, 
and are benefited by the exercise: for sleep soon comes 
in to replenish the store-house. But if we exercise vio- 
lently, or continue it too long, we exhaust the excitabi- 
lity too rapidly, and unequally, and disease or inability 
to proceed, follows. 

After a certain expenditure of excitability, the body 
begins to languish; and we feel a propensity to sleep. 
We place the body at rest and endeavour to avoid the 
stimulus of light, sounds, and motion and thought: thus 
situated, sleep kindly accepts the invitation, and spreads 
her veil of temporary oblivion over every sense. We 
pass several hours unconscious of existence, if thus com- 
fortably situated; but if loud sounds assail us, this mild 
goddess of the night, retiring in alarm, the senses ex- 
perience a temporary confusion. 

It has been remarked that old age resembles child- 
hood; but in respect to sleep, there is a vast difference. 
While the child during sleep seems buried in death, 
and may be carried from place to place without waking, 
the aged generally find their sleep slight and imperfect. 
How the excitability is restored, during sleep, we can- 
not even guess; but we know, sound and refreshing sleep 
can only be had by avoiding stimuli, to a certain extent. 
The stimulus of air on the lungs, and that arising from 
an increased circulation during sleep, are the only sti- 
muli absolutely necessary; a moderate stimulus from 
food in the stomach, is probably favourable to sleep. I 
shall speak more particularly when treating on the non- 
naturals. 

I have also said, mind is dependant on a suitable con- 
formity of bodily organs. Let us then extend charity 
and forgiveness to those who do wrong, and endeavour, 
by example and kind measures to reclaim them. And 



OF MIND. 55 

if we see the mind dormant in the idiot, let us not un- 
charitably suppose the Almighty has forsaken him. The 
capacity of mind is still there; and unfettered from its 
prison, may rise clothed in glory, even without blemish. 
Is thy brother, then, thus afflicted in this life? Take 
heed, lest your lustful passions shall condemn thee, 
while he fares well. From the lowest grade of idiotism, 
let us view man as destined for immortality; nor dare to 
despise him. 

Bv Revelation we are bound to believe, that man is 
accountable for the deeds done in the body; and it is ex- 
perimentally known that the sum of happiness, of any 
community, is proportioned to the practice of virtue in it. 
It is also experimentally known, that drunkenness not 
only impairs the mind and body, but that it completely 
destroys the moral faculty in many persons. Drunken- 
ness being generally the source of other vices, is a hei- 
nous crime, and ought to be named infidelity. 

SECTION VIII. 

Of Mind. 

On a slight view, it may be thought, medicine has 
little to do with the mind; but on a little reflection we 
will find, that in civilized life, at least, the person who 
has not some knowledge of the mutual influence of mind 
and body, is neither acquainted with disease, nor capa- 
ble of administering relief. I shall not pretend to any 
nice distinction of the attributes of mind, or attempt any 
conjectures of its nature, further than to give a few clear 
positions, from which a few practical inferences may 
be drawn. 

First. Mind, as associated with animal life, is a ca- 
pacity merely, and therefore, it is through the senses only, 
we can awaken and exercise it into reasonable maturity. 

Secondly. Mind active, or dormant, resides in every 
human creature; and being a created something, must 
be subject to change; for nothing but Deity can be im- 
mutable. 



56 SUMMARY OF 

Thirdly. Every thing subject to change must be sus- 
ceptible of deterioration, as well as improvement. In a 
rational creature, there can be no merit, and probably 
but imperfect enjoyment, without temptation to do evil. 

Fourthly. There resides in every human creature, a 
moral faculty, or power of distinguishing right from 
wrong; if it sleeps among sound brainular organs, it must 
be for want of incitements to awaken it. 

Fifthly. Disease may impair every attribute of mind, 
the government of the passions, the memory, will, judg- 
ment, all, are often impaired by disease — nor is the 
moral faculty, exempt from the operation of physical 
causes. 

Sixthly. Mind, although connected with sensible or- 
gans, is wholly independent of them in one respect; for 
when the body shall perish, the mind shall enlarge, and 
flourish in renovated vigour, till a new body rising up 
at the smile of our Saviour, shall unite therewith and 
form a new creature, destined for immortality. A God! 
a Heaven! a creature immortal! all these! in view of man, 
ohl favoured mind of man, how art thou exalted; how 
canst thou then, refrain from aspiring with constancy 
after this, thine destinity. 

I have said mind is a capacity only, how much then, 
does it behoove us to improve it with the most sacred 
care. It is a luxuriant soil, and unless instruction, and 
example shall awaken the mental faculties to the prac- 
tice of virtue, vice, like the weeds of our gardens, will 
grow vigorously; for the seeds are within, and bad ex- 
ample is never wanting, for corrupting the weak or un- 
thinking. Now, virtue under every form is temperance y 
and therefore, by the constant practice of it, we improve 
both mind and body. 

SECTION IX. 

Summary of Physiological Sketches. 

Having now arrived at the end of my observations on 
the healthy body, I shall conclude with a very short re- 
capitulation; and then enter on the nonnaturals, on the 



PHYSIOLOGICAL SKETCHES. Qj 

morbid pulse, and give some directions respecting bleed- 
ing, before I treat on the diseases to which we are sub- 
ject. We find the human body a wonderful assemblage 
of parts: moving solids, and moving fluids; with organs 
of perception, constitute this complex, yet beautiful li- 
ving system. We find it undergoing perpetual renewal; 
for which purpose we must immerse it in air, defend it 
from the cold, and sustain it by food and drink; enjoy 
its reasonable animal pleasures; and lastly, we find a 
powerful mind, evolved from the exercise of the various 
parts of the body. 

We find the mind capable of directing us, and destin- 
ed to lead to immortality. If, then, we find our bodies 
beautifully formed; let us not forget they are feeble. If 
we find life vigorous; let. us not forget it is short, and 
uncertain. If we find man destined for immortality; let 
us not forget, we may lose its blessings. If we find a 
mutual connexion between body and mind, let us with 
equal care nurture and defend them. Enjoyments! 
health! and future prospects! are bottomed on temper 
ranee and activity] 



$ 



OF THE NONNATURALS. 



PHYSICIANS under this name include air, food and 
drink, sleep, clothing, exercise, excretions, and the pas- 
sions I shall take them up in the order in which they 
have been mentioned, and endeavour to give a few gene- 
ral rules, respecting each of them. 

SECTIQN I. 

Of the Mr. 

The*atmospherick airwhich we breath, is a compound 
of two ingredients, called oxygen, and azote, diluted 
to a great extent by heat. Oxygen is the vital part, 
while azote, is even deleterious; they exist in the pro- 
portion of about twenty-seven of the former and seventy- 
three parts of the latter. This at first view seems a 
small proportion of the sustaining principle, but, on ex- 
amination we find more oxygen would hurry on life too 
rapidly, and would soon exhaust the powers thereof. 

We know, that a variety of salts, &c. can be dissolv- 
ed in the same water; in like manner, a great many ar- 
ticles will dissolve in air. The dissolving power of the 
air, is much greater than is generally imagined; almost 
every substance in nature may be dissolved in it; even 
the metals can be volatilized, and suspended in the air. 

The sense of smell discovers a great variety of float- 
ing bodies, in the air we breathe. 

We are here met by a surprising fact; so regular is 
nature in many of her most important laws, that a de- 
viation from them can scarcely be found. While the air 
of the mountain is light, and that of the valley heavy, 
and that of the city loaded with millions of effluvia; still 
we find the proportion of the two great component parts^ 



OF THE AIR. 50 

to be ever nearly the same. The most accurate chymi- 
cal experiments finds the air of the city, and that of the 
country alike. 

We fill the surrounding air with myriads of arti- 
cles, arising from our ravages on natural and artificial 
substances; we contaminate vast quantities by our bodies; 
yet bounteous nature, from her immense laboratories, 
pours out quantities inexhaustible. 

From pole to pole, from mountain to mountain, from 
sea to sea; or from hillock to hillock, this precious balm 
of life sweeps the surface: true as the sun to his celestial 
course, this second parent of organization and life, in- 
cessantly displays her charms, and without price, gives 
to myriads of creatures conscious existence. 

It is only in obstructing her course, or wantonly fil- 
ling the space around us with filthy effluvia, that in ge- 
neral begets the evils arising from the air. 

We are however, compelled to acknowledge, that 
here, as in many other cases, the Creator has thought 
proper to mix evil with good; and with the good gift, 
lias made the mild breeze to come sometimes loaded 
with disease and with death. 

And at times, the air, as if alarmed at its own Ian- 
gour, seems to take an alarm, and rising up in terri- 
ble majesty, pours out, with irresistible force, her pow- 
ers; and drives the sea into mountains of water, or with 
a single sweep, prostrates a whole forest. 

It is an unquestionable fact, that we are under a great 
weight of air. If we set a tube, a pump -stock for in- 
stance, in water, and exhaust the air by means of a pis- 
ton or sucker, the water will rise about thirty-two feet 
without any force; hence it follows that we move under 
a column of air, which, is equal to the weight of a co- 
lumn of water thirty-two feet. This is a great weight; 
but when we consider its application to the surface of 
our whole body, it will appear an immense load. From 
this, we may plainly see it is not necessary for us to 
€lraw air into the lungs; if we empty the lungs by con- 
tracting or lessening the chest, the heavy air rushes in» 

To be healthy, it is probable nothing is necessary but 
a due proportion of oxygen and azote; a reasonable 



60 Or THE AIR. 

temperature, and elasticity, comes as a matter of course. 
However, happily for us, many articles floating in the 
air do us no material injury; neither is great precision 
necessary, as to temperature: man enjoys health almost 
from pole to pole. 

Believing as I do, that no one will doubt the influence 
which air must have over us, nor that it is susceptible 
of, and actually does take up a great variety of articles, 
many of which are unhealthy, as the effluvia arising 
from marshy grounds, covered with decaying vegetables, 
(the source of agues) or the seeds of some diseases, as the 
smallpox, I think it necessary to give a few general di- 
rections. 

Houses ought to be built in open, high situations, so 
that nuisances may be washed away, and that we may 
have a free circulation of air. 

We should carefully remove all tilth from about our 
houses; and remove our manure frequently, and endea- 
vour to cover it with the earth as soon as possible. 

We should white-wash our houses frequently with 
lime: the papering of common sitting-rooms, or bed- 
chambers, is certainly improper. 

We should burn all the useless offals of our kitchens., 
and of our manufactories, that we cannot convert imme- 
diately to manure, and have removed. 

We should not confine ourselves too much at night; 
exposure to the night dews is generally unhealthy; but 
our bed-rooms ought to be very spacious, or well venti- 
lated. If you dread leaving open your door, or windows, 
in summer, at least, you ought to have ventilators in 
your doors or windows. It is always best for but few 
persons to sleep in the same room. 

Endeavour to avoid ponds of stagnated water; and if 
you cannot remove them, keep vegetable, or dead ani- 
mal substances, as much from them as possible. 

Too many trees near your house cannot be whole- 
some; they at times keep up too great a moisture, and 
at all times they give out unwholesome air at night: it 
is a fact, that the vegetables which to the light of day, 
give out oxygen, to the darkness of night, give nothing 
but foul ; carbonated air. A good garden near the house, 



OF THE AIR. 61 

with your trees at a reasonable distance, is both beauti- 
ful and healthy. 

Children ought to he freely exposed to the air: it i§ 
better to expose them to severe cold, or even wet by 
times, than to keep them too close. 

Cities, in general, are destructive to health; but it is, 
perhaps, more owing to obstructions given to the current 
of air, and to filthiness, than any other cause; and hence 
it is probable, modern cities are much more healthy than 
ancient ones; because, our streets are more open, and 
eur rooms more spacious; we are more cleanly, and with- 
out walls or ditches: with due attention to these things, 
it is probably the old tales of contagion will soon be for- 
gotten. 

All large manufactories ought to be in the country, 
and remote from cities. 

We ought to have as few animals in cities as pos- 
sible; they contaminate a great deal of air, and leave 
much filth. 

We ought to bury our dead reasonably remote from 
cities, and when convenient, they should be enclosed in 
metal coffins. 

We ought to build our churches of the most substan- 
tial materials, as best brick or stone; they ought to be 
spacious, openly situated; built high, with large doors 
and windows; they should be freely ventilated, by 
opening the doors and windows often, or have large 
ventilators; they ought not to be kept dark; the sun 
should be admitted freely every day. In damp weather 
they should be well dried with stoves, even in the sum- 
mer. The floors should be often cleaned, as well as 
the seats; and the walls should be frequently white- 
washed. With these precautions, the valetudinary 
would have nothing to dread from going to church. But 
as things now stand, it is a lamentable fact, that many 
delicate persons are seriously injured by going to 
church, because they are damp, poorly ventilated, con- 
stantly kept dark, too small or too low, or perhaps de- 
caying, or in stifled, low situations; or loaded with filth 
on the floors, seats and walls. 



62 " OF ALIMENT. 

If you would approach the Supreme Ruler, let it be 
the first wish of your heart, when you come more particu- 
larly into his presence, to come clean and pure; and into 
a place suitable to the great errand on which you go. 
For even an approving and accepting Heavenly Father, 
has chosen in general, to bless his people by the opera- 
tion of general laws. If these are not attended to, our 
work is often lost, because He in his providence has or- 
dered that man shall only reach the throne, through his 
own efforts, aided by the intercession of the lamb, which 
shed light over the world! then died to rise in new 
splendour! not fierce like death, but lovely as love] 
which is the great "I am that I am." (See Exodus, 
chap. 3. ver. 14. and also the Spectator. 

SECTION II. 

Of Ailment. 

Such is the amazing variety of nature's bountiful pro- 
vision of aliment for man, that I consider it preposterous 
in the extreme, to attempt any thing like a particular 
account of each article, for such is the variety of arti- 
cles: such the idiosyncracies in the human stomach, that 
volumes would not suffice to point out the particularities 
of each case. 

In as much as every man must have a stomach of his 
own, you might as well look for a similarity of features 
in the face, as for stomachs precisely alike; and there- 
fore, no very precise rules can be laid down. Nay, 
more, the very same stomach is liable to great chauges, 
so that articles that were once the most agreeable, be- 
come unfriendly and even dangerous. 

Let us not then pretend to too nice a distinction, for 
it is a true saying, that what is one man's meat, is ano- 
ther man's poison. I shall therefore confine myself to a 
few general remarks, for much must be done by each 
individual whose stomach is impaired, to discover what 
articles are most agreeable. Fortunately, the generali- 
tv of mankind have little to dread from all common ar- 
tides of food, unless they are used in excess. 



OF ALIMENT. fr£ 

That we, as creatures of nature, are subject to natu- 
ral laws, must be clear, but we may mistake our own 
shallow conceits for her laAVs. Men have been found 
advocating the using of our food, as near a state of na- 
ture as could well be, and bence comes the custom of 
eating raw beef. But I think, a little inquiry will con- 
vince us, that man was not designed, like the lion of the 
forest, to eat his animal food raw; because, the using raw 
animal food almost invariably begets a ferocious dispo- 
sition. Did man long after the bleeding carcase, — wo 
be to the world, for it would be a scene of horrour, and 
desolation. 

Perhaps the only thing which invariably and abso- 
lutely distinguishes man from all other animals, is his 
knowledge of the use, and proper management of fire. 

The daring ourang outang walks the forest, and 
mocks the proud erect walk of man. Many animals 
# i; *cover a sagacity which may well surprise us, but 
man only, under all circumstances, perceives the use of 
fire, and applies it to his wants. Although we must 
acknowledge some few exceptions, mankind in general, 
apply it to the preparation of their food. 

Now as there is not such a thing as half truths or half 
laws in nature; it would seem to follow as a fair induc- 
tion, that we must either take a thing wholly from na- 
ture, or trust wholly to her own process. If you take 
nature for your cook, be consistent, and use your ani- 
mal food reaking in its blood, and not carry it to your 
table scorched on the outside, and bleeding within; this 
is a mockery of nature, a slur upon your cook, and the 
bane of your health. It follows, that I am an advocate 
for having animal food well done. 

The animal food of the United States consists prin- 
cipally of the following familiar articles; and as stand- 
ing articles, they are used most in the order in which 
they are mentioned: beef, pork, mutton, veal, poultry, 
and fish. All of these in common use, are wholesome 
agreeable food, when used tempera tely,. 

Where circumstances do not forbid, they are best used 
fresh, being more wholesome and giving more nourish- 



64 OF ALIMENT. 

ment. More vegetables ought to be eaten with salt meat 
than with fresh. 

Eggs, butter, and cheese, are articles in very common 
use; in moderation they are all sufficiently wholesome, 
but I have no hesitation in saying too much cheese is 
used, and too much rancid butter, in this country, If 
butter cannot be had nice and fresh, the better way is 
to melt it in small parcels at a time, and use it in pies, 
dumplings, &c. , 

Butter should always be eaten sparingly, and rather 
than eat it rancid, take dry toast. I also think I may 
with propriety say, too much salted meat, and fish are 
used, if not generally, at least in many families. It 
must be obvious to all, that persons who labour hard, 
require more solid animal food than those who lead se- 
dentary lives. 

Too much animal salted food, is neither nourishing 
nor wholesome; persons who use it freely must use ve- 
getables, or scurvy is the consequence. 

The United States are blessed, in a peculiar manner, 
with a variety of the choicest vegetables suitable for 
bread, and every other purpose; and also plenty of fruit; 
many of them natives, and others which prosper abun- 
dantly with us. 

First in value, as food for man, we may place wheat, 
rye, speltz, Indian corn, potatoes, barley, rice, and buck- 
wheat. Bread for common use, is probably best made 
of a mixture, of wheat or speltz, with corn, or rye, or 
even both. 

To make good bread it must be well raised, but to 
talk of fermenting dough, in the common acceptation of 
the word, is wrong; but there is a peculiar fermentation 
which dough undergoes, very properly called the bread, 
or panary fermentation. This species of fermentation is 
very rapid, and in general, the more rapidly dough is 
carried through it the better; for it soon changes into 
the acetous fermentation, which at once sours and spoils 
the bread. With good sweet yeast, warm flour and wa- 
ter, and a warm place to keep your dough; not more than 
an hour will be necessary to raise bread. It is well as- 
certained, warm or very fresh bread is not wholesome; 



OF ALIMENT. 65 

m general, I would recommend to families to bake twice 
a week. 

Frequent changes of the lighter kinds of bread, is 
pleasant and wholesome; but in general they are eaten 
too warm, and with too much butter. A suitable portion 
of molasses, honey, or apple-butter, will be more whole- 
some; and to those in good circumstances, who prefer 
either of the above mixed with their butter, they will 
find it more agreeable to the stomach. 

The poor of the United States neglect the use of the 
potatoe, shamefully. It would be better for them to use 
potatoes as a standing article, than either rye or buck- 
wheat; and it would often be in their power to procure 
a nourishing food, for a large family, from a very small 
patch, which would not cost but a few days' labour; for 
nothing produces more abundantly; and I have no hesi- 
tation in saying, they are infinitely better than bad-made 
bread, even from wheat. Many men of firm stamina, 
and lively, vigorous minds, have been raised on this ar- 
ticle, with milk. 

The sweet potatoe is also very nourishing, and a good 
substitute for bread; but is of difficult culture, except in 
a very few places. The common potatoe thrives every 
where, with reasonable care; and easily could a poor 
man raise as many with a hoe, as would feed a cow, and 
support a smart family with a reasonable portion of ani- 
mal food. Such people would gain in health what the 
rich lose by living too high. The poor man will labour 
a whole day for a bushel of wheat, and very often less; 
in one day he could perform labour equivalent to that of 
raising twenty bushels of potatoes; from these he gives 
no miller's toll; but the tenth of a good crop will keep 
a hog, which yields in time a delicious feast of meat, 
sausage, &c. But, unfortunately, even the beggar, in 
this country, would be ashamed to be caught making a 
meal without bread: such is the prejudice in its favour. 

Before quitting this subject, I beg leave to say, we 
use a great deal too much bread in this country. The 
vast number of mills which every where prosper, plain- 
ly show it. If the rich, with whom the toll is no object, 
prefer filling the stomach with light bread at every meal, 
9 



6ij OF ALIMENT. 

let the poor be assured, that by using much of his grain 
boiled, he not only saves the toll, but, may also save 
himself from a great deal of trouble, loss of time in 
borrowing horses, &c. for which he often exposes him- 
self to the frowns of his neighbour. Nothing is more 
pleasant than well-boiled hominy, or boiled barley, or, 
where it is cheap enough, rice, and nothing is more 
healthy; and even in the use of his flour, and of Indian 
meal, much fuel will be saved by using them in dum- 
plings, &c. Children are universally fond of dumplings, 
puddings, &c. and I am satisfied they would nourish a 
king. 

While speaking of the potatoe, let us not forget that a 
great patriot, a Marion, was not ashamed to dine before 
the proud Britons, on this root alone. 

No vegetable, perhaps, in the United States, is so 
much neglected as the beet; we seldom see it unless in 
a slice or two of pickle, and yet nothing is more palata- 
ble, when well boiled and eaten as sauce; nor more 
wholesome and nutritious; besides, nothing will yield 
such an immense crop from good ground. 

The poor also neglect the onion; eaten raw, as they 
generally are, they are harsh and indigestible; but when 
well boiled, are a mild nourishing article. 

We are blessed with an astonishing variety of vege- 
tables, in the form of leaves, roots, or fruit; those that 
are eatable, are generally known, and require little to 
be said respecting them. Ripe fruits are best used as 
nature matured them, but we preserve such as will not 
keep, in sugar; in this form they should be used more 
sparingly. Unripe fruit can be used in moderation with 
safety, cooked with sugar. 

Vegetables, if cooked at all, should be well done; for 
by merely parboiling them, you toughen and render them 
more difficult of digestion. 

A reasonable proportion of condiments are at all times 
necessary with our food, whether animal or vegetable; 
of these, we have quite a sufficiency for the healthy sto- 
mach, in our own country: they are principally salt, mus- 
tard, horseradish, garlick, onions, red pepper, pickles, 
vinegar, &c. 



OF ALIMENT. 6^ 

It may perhaps not be generally known, that flour mo- 
derately sour may be rendered sweet, pleasant, and 
wholesome, by using a very little pot or pearl ash with 
it; the potash must be dissolved in a good deal of water, 
and mixed in making the dough; if you add too much 
potash, your bread will be yellowish, and unpleasant. 
This kind of flour is best used in the form of cakes, 
dumplings, and puddings; all of which it will make 
nice, pleasant and wholesome. 

With soups, formed of our meat and vegetables; our 
milk, with rice, hominy, potatoes, or mush, &c. the Ame- 
rican might pass the year, and at its end return the most 
grateful thanks to his Creator for having thus bountiful- 
ly blessed him; but this is far from being the case, and 
we are obliged to speak of foreign articles before we 
conclude. 

- And first comes coffee, this although an exotick, has 
in a manner become the second staff of life. Coffee no 
doubt, is a pleasant grateful cordial, when taken in mo- 
deration; but did not our country bless us with a plenty 
of substantial articles, we should soon become as lean 
as the king-fisher, on coffee. 

Nearly the same thing may be said of tea, when good, 
but much of our tea has lost its aroma before it is used, 
and of course, is inferiour as a mild pleasant cordial to 
many of the herbs of our mountains and gardens. 

Chocolate when good, contains some nourishment, but 
is less cordial than tea, or coffee, &c. too often it is made 
of rancid oils, or fat, and is then certainly less friendly 
than milk, in some form. 

Upon the whole, Ave would be infinitely better, was 
coffee, tea, and chocolate, banished the country; or at 
most, they ought to be reserved as in times of old, for a 
treat to a friend or for the sick. That they should have 
become principals in our diet, is a disgrace to our coun- 
try, and a high offence against the bounteous gifts of 
heaven. 

The people of the United States found a second pa- 
radise. They multiplied and rose, under a kind provi- 
dence, to be a great nation; great in industry; great in 
simplicity; great in unanimity; and great in plenty. 



68 ^ OF ALIMENT. 

Their cornucopse, spacious as the heavens which over- 
spread them, poured all the real comforts of life over 
their head, most pleuteously. And they were also ena- 
bled to spare a little for the luxuries of life; wines, spi- 
ceries, and a few other articles, were obtained in ex- 
change for the products of their soil: This, I fear, was 
the golden era of America; but would to (rod, I may be 
mistaken, and that my country as it ever has been, shall 
continue to be, the admiration of nations, and the fa- 
vourite of heaven. 

But ah! long since has busy ambition, pride, and ava- 
rice, the enemies of freemen, began their career — their 
daring, but smiling witcheries, have caught the rising 
generation, and with gigantick strides, like the bound- 
ing lion on the lamb, they are crushing the nation — rise, 
then, from your slumbers, ye growing angels,* and ra- 
ther lick the dust of your country, than satiate your sto- 
machs with the honey of Europe. There the poison 
lurks; then beware, and if you love your country, love 
her productions. She is the august parent of a Wash- 
ington; of millions of freemen, and of every rational and 
reasonable comfort. 

I shall conclude this article with a few r general rules, 
which, if attended to, may be useful. 

Vast injury is done by eating too much; therefore, we 
ought in general, instead of oppressing the stomach, to 
eat rather less than the appetite calls for. 

A suitable mixture of animal and vegetable food is 
not only to most persons most agreeable, but absolutely 
necessary. 

Our country abounds with milk; and we ought to use 
it plentifully. 

It is safer to exceed in a vegetable diet, than in one 
of salted animal food. 

In cold weather we may use oily articles more freely; 
thus nuts seem designed for winter; while, the greater 
number of fruits are suitable for summer. More vege- 
tables, therefore, in general, should be used in the sum- 
mer, than in the winter months. 

*Our youth, 



OP ALIMENT. 69 

It is always unhealthy to fill the stomach with two or 
three kinds of meat, fish, and cheese, at one meal, which 
is done by many persons every day: the more simple 
your meal the better. 

No one article of diet ought to be long continued; ex- 
perience justifies the belief, that those who use simpli- 
city in diet, but vary it almost every day, are the most 
healthy; and it certainly is most agreeable to most per- 
sons. 

The aged ought to eat the most succulent and nourish- 
ing diet; to eat very frequently, but never oppress the 
stomach; long intervals between their meals are extreme- 
ly pernicious; and I have no doubt but many are hur- 
ried away by inattention to this particular. 

Those, then, whose duty it may be to cherish the de- 
clining parent, should let nothing interfere with the pro- 
curing of them a constant store of savoury, nourishing ar- 
ticles; for of all the organs which receive impressions from 
suitable stimuli, the stomach is the last to yield to age; 
and I have said, (see animal life) that life is supported 
by stimuli. As a general rule, it will hold, that the 
aged need less salt and less spiceries, but more fresh 
animal food and cordial drinks; and never let them re- 
tire to bed without a reasonable supper of something so- 
lid; nor fast long in the morning. Their sleep is imper- 
fect, and they are distressed and exposed to danger if 
they do not obtain an early breakfast. 

It is improper to take the principal part of our food at 
one meal per day: it had better be four, and ought never 
to be less than three meals. Those who smile at the 
clown who takes his hearty breakfast and supper, and 
suppose he only can be genteel who takes all his food at 
dinner, may take care lest the gout turn their levity into 
sorrow. If I mistake not, this custom savours much of 
gluttony, and above all things, is calculated to enervate 
the body. They who practise it, have generally to force 
the stomach with brandy or wine; by this mea^s ihey 
may move the load slowly off the stomach; but it is like 
whipping a team through the mire, and never fails to ex- 
haust the powers of the stomach. 



70 OF ALIMENT. 

When habit does not forbid, supper is probably the 
best meal; but we are accustomed, from our infancy, to 
light suppers, and therefore, in general, although they 
ought to be reasonable, they should not be heavy. 

He who lives most on the products of our own coun- 
try, certainly lives most wisely, and will have the best 
chance for health. 

All our food, both animal and vegetable, should be at 
least perfectly sound; inattention to this will often pro- 
duce disease. 

To those who cannot do without coffee, I would re- 
commend the mixing the coffee bean with barley, or 
wheat; and am certain it would be healthy, and a vast 
saving to the country, Barley, if slowly and thorough- 
ly toasted, without burning, or wheat bread sliced thin, 
and toasted through, without scorching, will make a cof- 
fee pleasant and wholesome. 

Our posterity will probably blush, at some future day, 
to acknowledge, that for the luxuries of coffee and tea, 
we expended sums nearly equal to the proceeds of all 
our exports of eatables. The day may come when these 
follies shall be considered as extravagant, as the feasts 
of peacocks' tongues, of the vain of a former age. 

An observance of the foregoing rules, will generally 
be sufficient for those in health. For the valetudinary, 
and the sick, directions will be given in their proper 
place. It therefore only remains under this head, to say 
something respecting our drink. 

At first view of our drinks we are struck with a vast 
variety, but by a little reflection, we are taught that the 
base of all of them is water, and, as a diluent, it is per- 
haps, all that is necessary. But custom has adopted a 
great variety of pleasant drinks; some of which are 
slightly nourishing, and others cordial. 

A cordial, strictly speaking, is that which excites sen- 
sation, and involuntary motion, without giving any sub- 
stance or actual nourishment. 

Therefore solids may be cordial in their nature, as 
opium for instance, which in low grades of action in the 
blood vessels, gives comfort and strength, but certainly 
yields no nutriment. 



OF ALIMENT. 71 

The best idea which I can form of the action of a cor- 
dial is, that it operates immediately on the nerves, and 
through the sense of touch. (See the article, Sense of 
Touch.) If the body is cleansed, and soft, pleasant 
clothing applied, and we enjoy a fine mild air, we for a 
while feel almost a new life. We feel lively, strong and 
good humoured. Here we receive no actual nutriment, 
but are operated on through the medium of the sense of 
touch, by the pleasant stimulus applied to the surface. 

In like manner, when we take a fluid or solid cordial, 
it operates immediately on the nerves of touch, which 
exist on every surface, in or out of the body, and car- 
ries a grateful feeling to the brain; and thence, almost 
instantly, throughout the whole body. So far as my re- 
collection serves me, this opinion is my own; and I hope 
it will be found sufficiently simple and rational. 

Now, it must be observed, that cordials being a mere 
stimulus, and imparting to the body no nutriment, it can 
no more support us than the agreeable stimulus before 
mentioned on the skin; but both act as a mere spur on 
the living system, while the nutriment must come from 
other sources. On the other hand, if we apply some- 
thing very rough to the surface, or if we tickle a person 
violently, we produce pain, and exhaust the system, in 
proportion to the continuance of the violence; and through 
that very organ (the skin) which received the pleasura- 
ble impressions in my first case: we can tickle a person, 
perhaps, even to death. 

In like manner, if we take too much ardent spirit, or 
opium, without infusing one single particle of substance, 
or nutriment, we stimulate the nerves of touch violently, 
and produce a rapid exhaustion of the principle of life. 
All cordial drinks only give an actual support to the body, 
in proportion to the quantity of gelatin, oils, or sugar, or 
water, which they contain. Alkohol, the base of spiri- 
tuous drink, is wholly different from any thing existing 
in the vegetable, from which it is produced by fermenta- 
tion, and before it can enter the circulation must be de- 
composed. 

Like the spur which goads on the horse, with spirits 
we drive on the powers of life to great exertion, and soon 



7& OF ALIMENT. 

exhaust every energy, without adding one single parti- 
cle of support. 

When we consider through how many different mine- 
ral articles water passes, many of which are unwhole- 
some, and that many places have no pure spring water 
at all, we are compelled to acknowledge, that man is 
sometimes obliged to prepare other articles for drink. 

When pure water can be obtained, it is probably the 
only beverage necessary; but a little variety is pleasant, 
and perfectly wholesome. The articles in most general 
use in this country, are malted beer, cider, cideroyal, 
metheglin, mead, molasses-beer; all of which are plea- 
sant and wholesome. 

Many other articles may be used to advantage, such 
as molasses and water, milk and water, butter-milk, &c. 
Malted beer is the most nourishing; but, for common 
use, contains too much bitter. The bitter is principally 
necessary for preserving the beer, and therefore, if we 
were to use it pretty fresh, less hops would do. 

It is a great misfortune that, where those things are 
made a business of, men are too often disposed to impose 
on the publick by adulterations. The London brewers 
are known to use vast quantities of aloes. 

Bitters seem to operate on the body much like cor- 
dials; they stimulate, but give no nutriment. 

It would be best for every family to prepare their own 
drinks. 

I have said the ahove articles were in most general 
use; I mean such as are wholesome as common drink. 
But it is a lamentable fact, that grog, and the use of ar- 
dent spirits, are the favourite drinks. These liquors, 
as an occasional spur to the languid, or for those expo- 
sed to much dampness, or those who labour in the sun, 
may be useful; but perhaps habit has a large share in 
rendering them necessary; and under all circumstances, 
when used freely, they are destructive of the healthy 
operations of body and mind. 

Many of our fruits yield wine, which becomes fine and 
wholesome, when of sufficient age: what a contemptible 
thing, then, that we must have all our wines from abroad! 
Nature, although ever bountiful, is punctilious; and he 



OF ALIMENT. 73 

who tramples on her favours is sure to be corrected: she 
is slow to anger, but sorely avenging when provoked. 

If you would woo her, use the productions of your 
country as standing articles. Disease, or loss, swims in 
every glass of foreign liquors. 

We shine in war — we spread a dazzling splendour 
over the seas — we flourish as statesmen, and are exem- 
plary as patriots; but, in our domestick concerns, we ex- 
hibit a degrading contrast in the eye of Europe. 

In vain we pursue the horrours of war, the terrours of 
the sea, or the ennobling paths of science, while we seek 
our nutriment, &c. from other countries. 

It is a natural operation of the human mind, that 
where w r e seek aid or support, we are considered below 
the bestower. Thus the world witnesses our search 
abroad for a host of articles, which it would be too te- 
dious to mention; they naturally conclude we are "poor 
and naked," and if they knew all, might add, we are 
"blind" also. 

True national greatness consists in independence, not 
alone in our thoughts, but in possessing internal re- 
sources of every kind. I am not an advocate for a Chi- 
nese policy, but to admit into any country so much fo- 
reign articles as to render them principals in our wants, 
or so far as to leave the exchange against us, is unwise, 
and must entail disgrace and want. Posterity will weep 
over our infatuation, in consuming so many articles of 
foreign growth or manufacture; for by it we shall load 
them w r ith debt, and what is worse, with gout and myri- 
ads of nervous diseases. I shall conclude this subject 
with a few general rules, which ought to be observed. 

Endeavour to use succulent bland food, and you will 
seldom have occasion for much drink. 

If pure water can be had, let it at all times be a con- 
siderable part of your drink; water should be colourless 
and tasteless, without smell, and ready to mix with soap; 
with these properties it is generally good. 

It is better to suffer a little thirst than to load your 
stomach with fluids; they impair digestion. 

The aged require cordial drinks, but the young ought 
to use them with great caution. 
10 



74 OF SLEEP. 

Genuine old wines are the best cordials, and nothing 
stronger ought to be used by young persons; to be use- 
ful, they must be used sparingly. 

Ardent spirits should never be used early in the day; 
the excitability is then active, and too easily excited to 
the stomach; the consequence of this is, that the general 
system is robbed of a large share of its excitability, while 
the stomach suffers equally from an excess of it. Une- 
qual excitement is a strong predisposition to disease, 
and in the case before us, is extremely injurious to every 
constitution. 

It is the duty of all heads of families to prepare as 
much as possible of their drinks. 

Pleasant drinks can be made extemporaneously, by 
mixing a little fruit jelly with water; apple-jelly, cur- 
rant, strawberry, gooseberry, and many other articles, 
are pleasant in this way; this is perhaps the most allow- 
able way of using spirits, mixed with these vegetable 
juices and sugar. 

Domestick spirituous liquors ought to have a good 
age before they are used; many of them are su peri our 
to nine tenths of the foreign liquors consumed in the 
United States. 

Let us not forget, that all cordials are but spurs on 
life, and impart no real strength or substance to the hu- 
man body. 

These rules will be found sufficient for those in health; 
for the sick, directions will be found in another place. 



section in. 

Of Sleep. 

Those who are temperate, and use proper exercise, 
will in general enjoy sound sleep. It is, therefore, a 
subject on which much need not be said; a few remarks 
may perhaps be useful. 

People should consider it a matter of the utmost im- 
portance, to go to bed at a reasonable hour; and always 



OF SLEEP. 75 

vise early; this last will not only promote health, but is 
a source of profit. 

Children may be indulged in as much sleep as they 
desire: after about the seventh year they often require 
correction in this respect, for they are certainly prone to 
sleep too much. The best rule is to get them early to 
bed, and oblige them to rise with the family; this will 
bring them into a good habit. 

People in the vigour of life, had better not accustom 
themselves to much covering in bed, many constitutions 
are injured in this way. They ought not, in general, to 
sleep more than eight or nine hours in twenty-four; and 
in warm weather at least, ought to sleep on beds reason- 
ably hard. 

The aged should be laid as free from noise as possi- 
ble, their rooms ought to be warm, but not too close: they 
should have plenty of woollen covering, and good soft 
feather beds, when they can be had; and in general, they 
should take a little solid food before going to bed. Then- 
sleep is imperfect, and therefore they cannot easily sleep 
too much; a little sleep in general will be proper after 
dinner for them. 

All beds ought to be kept clean, often exposed to the 
sun, and the clothes, often changed; nicety in this re- 
spect is very essential, and the housekeeper who keeps 
nice clean beds, free from bugs, will always be found a 
good housekeeper in other respects. 

Sleep is often interrupted for want of a little nourish- 
ment in the stomach; to promote sound sleep, the brain 
must be duly stimulated, so that if you go to bed too lan- 
guid, or over stimulated, you cannot sleep, for there is a 
state of action necessary within, which has properly been 
called the sleeping point. 

The evening ougbt,if possible, to be ushered in with 
reasonable mirth. The practice of going to a neigh- 
bour's house, after the business of the day is over, is a 
great promoter of sleep. Nothing is more unfriendly to 
sleep than intense thinking, or angry operations of the 
mind; the checkered conversation of an agreeable neigh- 
bour relieves the mind, and above all, concord and plea 



76 OF CLOTHING. 

santness at home; leads to sound sleep; or pleasaut 
dreams. 

Never sleep with your clothes on, nor sleep in the 
daytime, if it can be avoided; if circumstances require 
it, undress when you lie down, (see the observations on 
animal life, in a preceding chapter.) 

SECTION IV. 

Of Clothing. 

This article is a source of vast expenditures to the 
people of the United States, and therefore, it must be 
evident that unless we make a good part of it ourselves, 
or exchange our products for it, that we must soon ex- 
haust our coffers. One might believe the present age 
supposed, that they too, like the lilies of the vallies, toil 
not, neither do they spin, yet Europe, clothed in all her 
glories, was not like one of them. 

Strange infatuation, that people should think all dis- 
tinction consisted of trinkets; and that unless their clo- 
thing is fashioned so, or so, they are disgraced. 

The guardian angel of our liberty, may weep over the 
shining tinsel, for it cometh not of our industry, but often 
at the expense of our posterity. Let the statesman 
dream of importing our manufactures, or, let the dashing 
beau tell you he gets his clothes cheapest in London, 
still, unless they can show you mountains of gold or sil- 
ver, or find a market for your products, it must be that 
they are indirectly enemies to their country. 

After all our pains to appear fine, it is a lamentable 
fact, that our citizens generally, especially the female 
part, dress too thin. Jt was the opinion of oue of the 
greatest physicians that ever lived, that more people 
died from inattention to, or want of clothing, than from 
the sword and pestilence together. We ought, there- 
fore, to use every precaution in suiting our clothes to the 
state of the weather. As a general rule, we ought to 
dress rather warm, than otherwise. 

We should not change too early in tlie spring, for the 
weather often continues very variable till we are well 



OF CLOTHING. 77 

advanced into the summer; and when we do change, it 
ought to be done gradually. 

Aged persons should, if possible, wear woollen next 
the skin; the want of suitable warmth is the greatest 
enemy the aged of this country encounter. 

People in vigorous life, who exercise freely, will pro- 
bably do as well without flannel, but for the sedentary, 
females generally, and children, they are always neces- 
sary. Children are certainly often injured by too much 
clothes, both in and out of bed: were it not for the wet to 
which they are subject, they would be better without 
flannel at all, for it is a fact, that they bear a great deal 
of dry cold, not only without complaining, but often to 
their advantage. 

It is necessary at all times to avoid tight garters, waist- 
bands, &c; they are productive of a great deal of injury. 

The great desideratum in dress, is to have it clean, 
loose, and sufficiently warm. Above all things, it is ne- 
cessary to have dry warm feet; this is best obtained by 
wearing strong leather shoes in wet weather; and our 
shoes ought to be well coated with oils and wax. The 
aged should have their shoes lined with soft woollens, or 
the skin of some animal, with the hair on. 

I believe the monstrous tight lacing which the young 
women wear, are not only the source of many diseases, 
but are really calculated to belittle the heart; and have, 
by the reflecting generally, been considered an evidence 
of a littleness of mind. 

This ungracious squeezing of the abdomen, confines 
the viscera of the chest, and makes a woman all sensi- 
bility: thus, while she startles at a feather, the woman 
of nature will meet death without much terrour. While 
she weeps over the tale of fiction, the woman of nature 
has her heart at home — while she faints at the sight of 
danger, the woman of nature big, yet good of heart, will 
defend herself. 

It seems to be much lamented that nature was so 
awkward in modelling woman. In all countries they 
seem dissatisfied with themselves, and are ever prone 
to improve their shape, &c. The Chinese women, by 
long torturing their children, have deformed their feet 



78 OF EXERCISE. 

until they are scarcely able to walk, and this they have 
done by confining the feet for successive ages, until it 
has become a part of their constitution. Can we doubt, 
then, that if the feet by pressure can thus be lessened, 
that the viscera may not also. There can be no doubt, 
but improper confinement does actually lessen the heart, 
and renders the woman feeble and irritable. I shall say 
more respecting this practice of tight lacing, in my ob- 
servations on the diseases of females. 

People who are much exposed to the weather, should 
wear oil cloth. Three or four shirts, or waistcoats, will 
afford more warmth than a great coat. 

section v. 
Of Exercise. 

This is of vast importance to man; what a pity then 
he is so prone to avoid it. Exercise is the great physi- 
cian of all animated nature, and without it human life is 
feeble, painful, and generally short. While we freely 
expend heavy sums for clothing and for food, this great 
source of health may be reached not only without price, 
but is in general, the source of constant lucre. How won- 
drous strange then, that man, from the remotest antiquity, 
has viewed exercise as a curse. It must be the natural 
state of rational creatures, for without motion thought 
was never elicited from a created being. Is it not through 
the exercise of the organs of sense that we expand the 
mind? 

Without motion, nature is dead, and void; but a be- 
nevolent God has impressed this property upon atoms 
and creatures, and worlds, and a universe! 

When we cast our eyes around us, we behold my- 
riads of creatures displaying their joyous gambols, whe- 
ther in the briny deep, the silvery rivers; on the verdant 
pastures, the beauteous flowers; or even the loathsome 
mire, or corrupting carcase, ally all teems with life, and 
life with motion. 

Or, if we raise our eyes to the celestial bodies, we s'ee 
all obedient to laws of motion; and shall man alone be 



OF EXERCISE. 79 

exempt from this universal law? Heaven has forbit it! 
Shall the bright morn be ushered in by the melody of 
the plumy songsters — by the lambs, sporting over the 
green pastures, and by millions of living creatures, while 
lazy man slumbers on beds of down? Nature has forbid 
it, nor will she pardon the transgressor, for it cometh of 
perversity! 

The great body of the American people are in habits 
of constant exercise, but in general, they are unmindful 
of its advantages, and many of the athletick agricultur- 
ists, blessed with all the real comforts of life, sigh for 
the enervating habits of the city. 

Our cities have grown with a rapidity unparalleled, but 
like the hotbed, they are rearing many tender plants^ 
and with rapid strides we are endeavouring to raise a 
race of people, who shall sleep on down, live on luxu- 
ries, and hold wholesome exercise in contempt. 

Parents who have been raised with firm stamina, from 
exercise, will bear relaxation from labour in the decline 
of life; but the rising generation despise the habits of 
their ancestors, and seem to aspire after mind without 
body; but experience teaches us that healthy, sound or- 
gans, are essential to vigorous mind. 

Let me admonish every member of society that they 
owe it to society, to themselves, and to their Creator, di- 
ligently and actively to exercise, if not for lucre, for 
health. Surely it must be a vicious crime to shut your 
eyes against reason and experience; and does not ex- 
perience teach you that idleness entails disease and vice 
on your offspring? 

The guardian angel of your health cannot smile pro- 
pitiously on the rebellious sloth; but while she weeps 
over your folly, active Pandora shall fill your veins with 
poison. 

It is one of the great mysteries of this world, that in 
no one thing is there a more universal agreement among 
mankind, than as to the salutary nature of exercise; and 
yet there is nothing which they are so prone to avoid; 
and this has been the case from the remotest ages. 

Many are seen wallowing in idleness and intempe- 
rance, and seem to enjoy good health, even to a good old 



80 OF EXERCISE, 

age; but besides the heinous crime of bad example, they 
generally entail disease on their posterity. There is un- 
questionable evidence on record, that temperate offspring 
have kept down gout till the second generation; and that 
then, without any change of habits, the lurking gout of 
the grandfather has burst out like a ravenous wolf upon 
whole families. Who then can doubt, but idleness and 
intemperance may implant disease in the child, while the 
father, by superiour force of constitution, shall escape. 

Man can never be an insulated being; he owes it to 
his country to marry; he owes it to his offspring, and to 
his Creator, to conduct so far as in him lies, to avoid en- 
tailing misery on a living creature; but that the father 
should, for the gratification of appetites, which would 
disgrace a brute, run the risk of inflicting incurable mi- 
sery on his offspring, is fit work for a demon. 

It remains to offer a few remarks on the regulation of 
our exercise. 

By labour, the circulation is augmented, the lungs di- 
late more freely, and thus enable the ambient air to 
drive home the oxygen, and impart to the blood the re- 
quisite of vigorous life: a healthy blood lays down heal- 
thy solids, and action propels the blood through every 
fibre, and gives the glowing colour which constitutes 
"beauty without paint." But, to be useful, it must not 
be excessive; and he whose employments lead him to 
great exertion, must be cautious; or, by too rapid action, 
he exhausts his powers and brings on disease, or pre- 
mature old age. Exercise, then, to be useful, must be 
constant, and regulated according to the strength. But 
as capital in dealing increases in a certain ratio, so from 
exercise, properly regulated, we obtain a constant acces- 
sion of strength. 

Those who exercise in carriages, ought to partake of 
it freely, otherwise it will be insufficient; and in general, 
they should walk a good deal; for it surely never was 
intended by nature that man should not walk: she has 
given us no carriages, save the graceful carriage of a well- 
bred person, who has strength to walk freely without fa- 
tigue. It is in the employment of walking that man or 
woman display their charms: with what ease and ma- 



OF EXERCISE. 81 

jesty moves the well-bred man or woman with firm mus- 
cles! At such a sight, all nature may smile and angels 
approve. 

Next in point of natural dignity, appears the stately 
man or woman on the prancing steed, who, disdaining 
inaction, presses on with his precious guide, and while 
he passes on with a celerity which is truly astonishing, 
at command he stays, and Leaves his sprightly rider re- 
novated in every fibre. People of cities! if you value 
your children put them on horseback: let them learn to 
admire this noble animal, in preference to the glittering 
carriage. If you want healthy children, encourage ri- 
ding-schools; it is better than dancing, because it is use- 
ful in every period of life. I consider this advice of 
vast importance. 

The health and constitution of a Cicero was renovated 
by riding on horseback. 

I would most seriously advise every person, who is 
able to keep a country seat, to keep their horses there, 
and use them freely. When our youth are seen daily 
on horseback, we shall hear less of consumption. Phy- 
sicians for ages have recommended this mode of exer- 
cise, to the valetudinary, and to those in health also. 

It would be a good rule with sedentary people, who 
walk for exercise, to take an agreeable companion; in- 
tense thought on such occasions, will destroy all the be- 
nefit of the exercise; the varied discourse of a friend, will 
relieve the mind from too close application. 

We ought not to exercise immediately after meals. 

Children seldom require any incitement to exercise; 
let them be indulged freely, and we seldom find them 
inactive. 

Inactivity renders the circulation languid, the oxyda- 
tion of the blood imperfect, loads the body with fat and 
glandular obstructions, impairs the tone of the muscular 
fibre; weakens digestion, fills us with wind and vapours, 
and spleen, and besides a host of evils to the body, ruins 
the spirits and tone of mind. 

I shall have occasion to speak of exercise in treating 
of consumption. 
11 



83 OF THE SECRETIONS. 

SECTION VI. 

Of the Secretions. 

The excretions from the body are many, as the alvine ? 
urinal, sensible, and insensible perspiration, expectora- 
tion, and a large discharge from the lungs in the process 
of respiration. 

It must however be evident on a slight view, that these 
are governed, so far as we have control over them, by 
the other nonnaturals. Attention to food and drink, ex- 
ercise, apparel, wholesome air, with a suitable control 
over the passions, will generally secure healthy excre- 
tions; or rather such as are conducive to health. It fol- 
lows, that I need only refer the reader to the other arti- 
cles under the head of nonnaturals; and to the sick pro- 
mise instructions when I come to treat on diseases. 

It may not be amiss to observe here, that obstructions 
of the secretions often occur without producing disease; 
but such disorders, at all times, predispose strongly to 
disease, and therefore we should never neglect to use 
some mild suitable means, when we are sensible of a di- 
minution of the excretions, as costiveness, small dis- 
charges of urine, and this of a too acrid quality; an un- 
pleasant dryness of the skin, attended with languor or 
some confinement or stricture about the breast. We are 
also to bear in mind, that we are liable to excessive dis- 
charges of all the secretions, which are equally injurious 
as defection of them. 
v 

SECTION VII. 

Of the Passions. 

These are, love, grief, fear, hatred, jealousy and anger; 
they seem to have appeared in the order in which I have 
enumerated them. 

In his primordiate and perfect state, man probably 
could only be affected with love and grief; love to the 
Supreme, to his fellow creatures, and for every created 



OF THE PASSIONS. S3 

being; grief might find place in contemplating the state 
of fallen angels; this, however, would operate as a zest 
to his enjoyments; not indeed that he could have felt 
pleasure in their misery, but by comparison, he could 
appreciate his own happiness. 

Fear, hatred, jealousy and anger, seem to be a part of 
the mental curse inflicted upon man, while a general de- 
terioration, impaired in great measure, the state of love 
and grief. Man seems to have felt the influence of fear 
immediately at his fall, for we are told, that God de- 
manded of Adam, "where art thou?" and he said, "I was 
afraid because I was naked;" and in the second verse 
preceding, we may infer, that Eve felt this passion also. 

Enmity being pronounced between the seed of the wo- 
man and of the serpent, the foundation of hatred was 
laid in the human breast. The other degrading pas- 
sions soon followed; for jealousy, rising up like a con- 
suming fire, in the breast of Cain, ushered in raging an- 
ger, and slaying a brother, full scope was given to all 
the foul passions which defile mankind! From this early 
period the passions form a part of our constitutions, and 
it becomes our duty to curb and regulate them by the 
precepts of religion; and avoiding the physical causes 
which operate upon them. 

Their operations are very different, but like the excess, 
or detraction of stimuli, they all centre in the same point. 
Although anger generally rouses the powers of the body, 
there are many exceptions, where anger enfeebles and 
renders the man pale and trembling; and this sometimes 
terminates in fear. All the passions, when in force, im- 
pair digestion, debilitate the body, and corrupt the mind. 
There is constitutional operations of the passions, we 
cannot always control, but ninety-nine hundredths of their 
effects are the result of our own conduct. They are the 
result of bad example, of intemperance in strong drink, 
or of our neglecting to curb them in time. 

When we see the dreadful effects of ardent spirits on 
the passions, how can we doubt the effects of ambition, 
avarice, and even intemperate eating. Idleness and ir- 
regularity of every kind may stir up the passions; cruelty 
to brutes is the source of many gusts of passion. 



8£ OF THE PASSIONS. 

A few words of advice shall close this article. Love 
is the highest attribute of a created being, but man hav- 
ing fallen, this passion suffered with him; and hence is 
liable to abuse or wrong direction. Therefore, in the 
exercise of this passion, let it be a sacred act of the judg- 
ment to determine whether the object is attainable, be- 
fore you advance, for it is a slippery path, and many 
would turn when in it, but fall, and fall victims, very 
often, to their indiscretion. 

If you find irritability of mind arising from long fast- 
ing, from want of sleep, from spirituous drink, &c. shun 
them as you value the welfare of your own health, and 
the peace, and quietness of your family, or those around 
you. 

If fear possess you, call up your faith; a sovereign re- 
medy here, is an easy conscience. 

If you find your passions generally unruly, apply 
more closely to business, recreations, or study. So close- 
ly are the organs of life connected with the passions, 
that death has been the forfeiture of indulging every one 
of them: Some of them are slow in their effects, but 
every age of the world, bears testimony of their fatal 
termination. 

There is an affection of the mind somewhat allied to 
the passions; but it is often artificial: and when it does 
not arise from diseased organs, (which is sometimes the 
case.) it admits of no excuse: I mean religious melan- 
choly; it has slain its thousands. Of all the human 
weaknesses this seems the most Strang-; that a rational 
creature should so far forget his duty to his fellow crea- 
tures, and the liveliness and loveliness of natural ob- 
jects, and more especially, that in contemplating a God 
who is all perfection and love, he should veil his mind 
in gloom. This affection often arises from habits impo- 
sed on themselves, by which they expect to become re- 
ligious in the eyes of men. To have a reasonable con- 
cern about our future prospects is the duty of all; but let 
b one endeavour to do his duty and trust in God, for 
he giveth to whom he will. The bright prospect opened 
to our view by tlie christian light will probably, some 
day, stamp joy! and loveliness! and continual rejoicing!, 
on the face of every rational creature! 



OF THE PULSE. 



I HAVE thought proper, before entering on a descrip- 
tion of diseases, and of the usual remedies for them, to 
give some account of the pulse, in a state of disease: and 
I hope I shall be excused for handling this subject pret- 
ty freely, for it is a subject which has been much neg- 
lected, and one which is well worth cultivation. 

I think proper to premise this article with a very short 
description of the circulating system. I have observed, 
in my sketch of anatomy, that the heart has four cavities, 
that the blood passes through these cavities in succes- 
sion, that the aorta, or great artery, arises from the left 
ventricle of the heart, and carries the blood from thence 
throughout the whole body. I have also observed, that 
the blood was carried through the heart, by means 
of a constant dilatation and contraction of its cavities; 
the first act is called the diastole, and the latter the 
systole of the heart. 

It follows, from the above facts, that at each and 
every dilatation of those cavities, that there must be a 
suspension of the projectile force, till they contract again, 
and thus a kind of interrupted motion is given to the 
blood, which we may resemble, in appearance, to that 
of a common pump, which although it keeps up a con- 
slant stream, brings the water through the valve, while 
the piston descends only; so with the action of the heart, 
its diastole and systole, are performed so rapidly that a 
constant stream of blood pours into the great artery, but 
still a jet-like motion is given to the blood; and this jet- 
like motion, arising from an alternate dilatation and con- 
traction, exists throughout the whole arterial system, 
and constitutes that beating so easily discovered in the 
wrist; this is what is technically called the pulse. It is 



86 OF THE PULSE. 

to be felt in the temples, neck, fingers, foot, and in 
short, exists throughout the whole system. 

Having now, as I hope, given a sufficient account of 
what is meant by the pulse, I have only to remark, that 
the action of the arteries is in some measure different 
from, and independent of, the action of the heart; and 
this position will be clearly established in detailing the 
variety of action, which occurs in the pulse, in a state 
of disease. 

To enter into any intricate disquisition upon the pulse, 
would be foreign to the intention of this work; therefore 
I shall confine myself to a few obvious and necessary 
distinctions, and conclude with a few observations on 
the information which we may derive from a knowledge 
of the pulse, and how far we may reasonably depend 
upon such information as a guide in cases of disease. 

When a physician speaks of a full pulse, he means 
that the artery is fully dilated or expanded, and conse- 
quently, that there is an increase of the arterial channel, 
and that this expansion is owing to a larger column of 
blood passing through the arteries. 

When he speaks of a corded or tense pulse, he means 
that the artery is more firm, and less yielding to the 
pressure of a finger upon it than usual: this state of the 
pulse may exist in the full pulse, the small, the feeble, 
and in short, in every other variety, except the soft 
pulse, and seems to be a spasmodick state of the mus- 
cular coat, or fibres of the arteries. 

When we speak of a quick pulse, it is meant that the 
artery contracts in the shortest possible period of time; 
its dilatation may be as long or longer than usual; so that 
the pulse may be quick, and not have more, or it may 
even have less strokes, in a given time, than the healthy 
pulse. 

When we speak of & frequent pulse, it is meant that 
the artery beats or pulsates rapidly; and this state of ac- 
tion may exist in the full, tense, feeble, soft, and, in 
short, in every state of the pulse, except the slow. 

An intermitting 'pulse is not very common: in this 
state of the pulse the artery may beat quick, full, feeble, 
&c; but after a certain number of strokes, there is a 



OF THE PULSE. 87 

pause for a short period of time, and this pause again is 
succeeded by a certain number of strokes. This kind 
of pulse is mostly unfavourable, and generally accompa- 
nies the hour of dissolution. 

A soft pulse is known by a yielding condition of the 
artery; that is, when we apply the fingers we can easily 
depress the artery, and it is free from any remarkable 
jerking of the artery. It is mostly accompanied with a 
moist skin. 

A feeble pulse is where there is but little action in the 
artery, and it may be applied to a state of direct or po- 
sitive weakness, or it may be applied to a state of indi- 
rect weakness, or mere oppression. Its most correct ap- 
plication, however, is to the former state only; for in 
cases of indirect debility, it is more correct to call it the 
depressed pulse. 

A weak pulse is synonymous with the term feeble 
pulse. But a depressed pulse, is that state of the artery 
which arises from oppression, and is a consequence of an 
excess of stimulus: it is to be found in malignant fevers, 
in cases where narcotick poisons have been taken, as 
spirits, opium, &c, in excess. 

A slow pulse is where the pulsations are repeated at 
longer intervals than usual. 

There is also what has been called the sliattered pulse, 
and also known by the name of the quill pulse: in this, 
there is a kind of indiscribable sensation imparted to the 
fingers, which is a kind of creeping, tingling or thrilling 
feeling; this is always an unfavourable pulse. 

There is also a state of the pulse which has been cal- 
led the locked pulse; and this, I suspect, is yet but im- 
perfectly understood. I think 1 have most generally 
found this state of the pulse, in common inflammatory 
diseases, of the highest grade, such as phrenitis and 
pneumonia, &c. 

The small pulse is such a state of the artery as suf- 
fers it to contract and lessen its column of blood; and 
this smallness of the artery may exist, and its action 
partake of the quick, feeble, frequent; but it is seldom 
soft. 1 have sometimes found the arterv small and soft 



88 OF THE PULSE. 



A TABULAR VIEW OF THE PULSE. 

1. A full Pulse 

Maybe quick, corded, slow, intermitting, or regular, 
seldom feeble in its beats. 

2. A tense or corded Pulse 

May be full, quick, slow, feeble, frequent, intermit- 
ting, small, depressed, shattered, locked. 

3. A quick Pulse 

May be full, frequent, corded, intermitting, feeble, 
soft, depressed, small. 

4. A frequent Pulse 

May be feeble, depressed, small, intermitting, soft, 
tense, quick, shattered, not often full. 

5. An intermitting Pulse 

May partake in its strokes, of the feeble, shattered, 
full, small, slow, quick. 

6. A soft Pulse 

May he full, small, feeble, but seldom if ever partakes 
of the other states of the pulse. 

7- A feeble Pulse 

May be locked, shattered, depressed, tense, small, 
quick, frequent, intermitting, slow. 

8. A slow Pulse 

May he full, quick, intermitting, locked, soft, feeble, 
depressed. 

9. A shattered Pulse 

May he feeble, quick, frequent, intermitting, depres- 
sed. 



OF THE PULSE. 89 



10. A locked Pulse 

May be tense, intermitting, quick, small, feeble, slow, 
shattered, 

11. A small Pulse 

May be quick, frequent, feeble, shattered, locked, in- 
termitting, depressed, slow, seldom soft. 

I come now to make a few applications of the differ- 
ent states of the pulse, and shall take them up in the 
order of the foregoing table. 

1. The full pulse is found, principally in persons 
of good constitutions, and in the vigour of life, when 
labouring under inflammatory diseases, as pleurisy, 
smallpox, measles, &c; and where it is simply full, 
quick, tense, and regular, the case is seldom dangerous. 
But where the full pulse is intermitting, or slow, it por- 
tends rather a more dangerous disease; and this kind of 
full pulse is often found in asthma in reduced habits, and 
in many diseases arising from mere irritation, or in other 
words, entirely independent of inflammation; nor is there 
any possibility of lowering this pulse by the lancet; on 
the contrary it seems to increase at every bleeding, the 
coats of the artery yielding more and more; this kind of 
pulse is found sometimes in hysterical, and what are 
called nervous habits; and where we know the habit to 
be really such, or where we find the pulse dilate, after 
reasonable bleedings have been practised, we may con- 
clude that the fulness arises from irritation or weakness, 
and can only be reduced by tonicks, or more especially 
by opiates. This state of the pulse, that is, the full in- 
termitting one, is generally attended with a huffy ap- 
pearance of the blood, and this seems to arise from the 
rapid action, which operates on the blood precisely as 
high toned action, in cases of inflammation; but the solids 
are in a very different state, and require the use of 
opiates and tonicks, and a suitable regimen, which, by 
giving tone to the solids, lessens this morbid force of the 
circulating system. The patient at the same time, is 
\2 



DO OF THE PULSE. 

carefully to avoid all irritating things, in food, drink, 
passions, &c. 

5, A tense, or corded pulse, often attends common in- 
flammatory diseases, particularly in those of rather weak- 
ly constitutions: in typhus and typhoid fevers, sometimes 
in malignant diseases: in a majority of cases, this kind 
of pulse requires the use of the lancet: but great caution 
is necessary in distinguishing between this f and the fee- 
ble pulse. 

3. The quick pulse does not particularly indicate the 
form or grade, or nature of the disease; it is to be found 
perhaps in every disease, by times, and in general, it is 
less dangerous than the very slow, or intermitting. Few 
persons pass through a state of convalescence from se- 
vere disease, without this state of the pulse: and an in- 
creased quickness, if accompanied with a general amend- 
ment, may perhaps always be viewed as the forerun- 
ner of health; this kind of quick pulse, however, is soft 
and tolerably full. 

4. The frequent pulse; it is remarkable of the fre- 
quent pulse, that, although it is to be found at times in 
every disease, and perhaps few persons pass through a 
severe disease without this state occurring at some time 
of it, yet a frequent pulse is by no means a certain sign 
of disease: exercise, frights, simple debility, &c. may 
excite the frequent pulse, so that we, perhaps, derive 
less distinct information from this state than any other. 

o. The intermitting pulse, generally portends danger, 
and mostly arises from congestion, or some visceral ob- 
struction; it is often found in cases where the viscera 
have been injured by some violence; and in these cases 
calls imperiously for the use of the lancet; it generally 
attends the hour of dissolution: but notwithstanding this 
unfavourable character of the intermitting pulse, I have 
sometimes found it in chronick rheumatism, and other 
diseases not particularly dangerous, so that we are not 
to give a rash opinion in cases where we find this pulse. 

6. The soft jmlse is natural to some persons when in 
health, but is particularly to be found about the crisis of 
a disease; and I think is always a favourable occurrence. 
In a pulse really soft, the artery is nearly natural, its 



OF THE PULSE. £1 

action, however, is often frequent, or quick, the strokes 
feeble, and in some few cases tlia artery is small. Much 
caution is necessary in distinguishing this from the feeble 
intermitting, or small tense pulse; such a mistake might 
be productive of great danger. 

7. The feeble pulse, correctly speaking, is a weak 
pulse; but in as much as a feeble stroke of the artery i9 
considered a feeble pulse, and as this feeble action occurs 
more frequently in inflammatory diseases than others, 
we are under the uecessity of distinguishing the feeble 
pulse by the circumstances of each case. And although 
the feeble pulse occurs in opposite states of the system, 
we still may designate this feeble action by bringing to 
view other states of the pulse. Thus, a pulse simply 
feeble, is an evidence of direct debility, or exhaustion 

of the body; and sometimes this kind of pulse may be 
small, and still favourable. But a feeble pulse that is 
locked, shattered, tense, intermitting, or depressed, is 
mostly found in inflammatory diseases; but to this there 
are exceptions; and, therefore, we are carefully to ex- 
amine into every circumstance of the case, before we 
can determine the character of the disease. I may take 
occasion here to observe, that the depressed, feeble, 
small and locked states of the pulse, are not to be dis- 
tinguished so much by the action of the artery as from 
the collective circumstances of the cases: but if we bear 
in mind that the pulse, really weak, is mostly soft, and 
that the feeble stroke of the artery, from excess of stimu- 
lus, or inflammation, is always tense, we may in gene- 
ral, judge with tolerable accuracy. 

8. The slow pulse is apt to partake of the locked pulse; 
and, perhaps, always is accompanied with excessive ex- 
citement: it is often found in cases of injury done to the 
brain; it also occurs in the early stage of many cases of 
malignant fevers. However, this condition of the pulse 
may be in some measure natural, and, therefore, it re- 
quires caution in examining it; but if we bear in mind 
the fact, that the dangerous slow pulse is, perhaps, al- 
ways irregular and mostly intermitting, we cannot' easi- 
ly err. 



9S OF THE PULSE. 

9. The shattered pulse is mostly a consequence of au 
aneurism, it is also found in malignant fevers: it is often 
present in the hour of dissolution, particularly in cases 
of inflammatory violence, which have not been subdued 
by the lancet, or other evacuations. I have also found 
it present in fatal cases of apoplexy, especially where 
there was an infarction of the lungs, which produced 
what is called the rattles: these cases were in the even- 
ing of life. 

10. The locked pulse, is found to exist, more or less, 
in all cases of very high excitement, such as malignant 
fevers; inflammatory fevers, of a lower grade; in affec- 
tions of the brain. But, I have said, this state of the 
pulse is not well understood; thus what is often taken 
for a locked pulse, is a depressed pulse, which has ad- 
ded to it, or rather is accompanied with tension, small- 
ness, and feeble action of the arteries: it is true, this is 
but a variety of the locked pulse; but as the artery is 
always tense, and acts with such an irregular jerking of 
the artery, we can seldom mistake this for the weak 
pulse — more especially if we carefully examine into all 
the circumstances of the case. But in a pulse really 
locked, no man could judge with any precision from the 
pulse alone; for there is almost a total absence of action 
in the artery; yet it is an unquestionable fact, that in this 
state of the pulse the blood pours through the arteries 
with great rapidity; this has been so clearly demonstra- 
ted to me in many cases, that I am quite certain the 
blood often circulates rapidly without almost any action 
in the arteries; for in the locked pulse, if you open a vein, 
the blood flows with impetuosity; and yet you can feel 
no action in the pulse, or rather there is no pulse. It 
follows, that in these cases we must judge from other 
circumstances; as, the patient's habits, the prevailing 
diseases, &c. I think I have observed, that in a pulse 

full and locked, which does not often occur, we can bring 
the arterial system most safely to its regular state by ab- 
stracting blood more slowly, and frequently repeated; 
for the dilated artery is an evidence of great prostration 
in those cases. But in the pulse locked and small, in 
general we may venture to bleed largely, by which ac- 



or THE PULSE. 93 

tion will soon be restored to the arteries. I think John 
Bell some where hints at this condition of the arteries.* 
But I beg leave to assure the reader that I was apprised 
of it before I read Bell's late works. It is true, the 
locked pulse was well known to Rush and others, but I 
do not recollect that any one was fully aware of the fact, 
that in the locked pulse the blood was circulating with 
increased impetus. And it is a matter of importance! 
for there still are many practitioners who cannot, or will 
not, see the propriety of bleeding where the pulse is not 
active. I beg leave to say to such, that this is a fact of 
which they can easily satisfy themselves; for if a patient 
of good habit is labouring under acute disease, (unless 
the prevailing diseases are well known to be of a low 
grade, and the pulse is found thus locked up, J by open- 
ing a vein they will find that the blood flows with impe- 
tuosity; and this is proof positive that we cannot rely 
on the pulse exclusively. 

11. The small pulse may be found in most diseases, 
as the malignant, typhus, typhoid; it is, perhaps, most 
common in the inflammatory condition; but is seldom 
found in pleurisy. In a low state of disease, as typhus, 
&c. it proceeds from weakness. In the inflammatory, 
or malignant, it proceeds from excess of stimulus or ex- 
citement. 

Upon the whole, then, we discover the pulse veiled 
with difficulty, and only to be tolerably understood from 
considerable application to its study in actual practice. 
To the experienced physician it is a good guide, but 
even the most experienced cannot judge from the pulse 
alone; we must, therefore, in examining cases of disease, 
proceed with extreme caution, and endeavour to investi- 
gate, by every possible means, the diseases prevailing: 
the habits and usual diseases of the patient, if subject to 
any disease; the eye; the skin; the tongue; pain; excre- 
tions; the state of the mind; the probable remote or 

* The author here named, more thati once observes, that, **to stop 
the beating of an artery is one thing, but to check the blood qifite 
another." And he intimates that, surgeons have sometimes been 
disappointed by trusting to pressure on arteries which stopped the 
pulsations, but not the blood. 



94 OF THE PULSE. 

exciting cause, &c. A discriminating judgment in those 
matters is the highest acquisition of the Medicince Doc- 
tor, and is only to be obtained by a long application to 
the study of diseases, under the direction of those who 
combine example with their precepts. 

By a careful examination of this subject, I think it 
appears that the terms applied to the pulse have been 
vague, and require correction: thus, for instance, a 
small pulse, a feeble pulse, a tense pulse, a locked 
pulse, a depressed pulse, are nearly the same thing as 
respects the action of the artery; and this, strickly 
speaking, is the pulse. But there is a material diffe- 
rence, at times, between these different states of the 
pulse: a pulse may be feeble and corded; feeble and 
really weak; feeble and locked; so that, in truth, the 
real or essential difference between the various states of 
the pulse is dependant, more especially, upon the con- 
dition of the nervous power, and that of the solids ge- 
nerally, than that of the arteries in particular; and it is 
a fair induction, from the foregoing account of the pulse, 
that no extent of experience can enable us to adjudge 
cases of disease without the most scrupulous attention to 
every other circumstance. 

And I hope I shall be pardoned here, for admonish- 
ing young physicians in particular, to ponder well, 
view and review every circumstance; never forget that 
there are indications and contraindications. I am led 
to make these remarks from the fact, that it is a trait 
in the character of the times, for physicians to prescribe 
with expedition. The wig of the Doctor, of the seven- 
teenth century, though it might often cover a weak head, 
and although I am by no means disposed to revive it, 
was nevertheless truly emblematick of the physician's 
character; for it behooves him, with all the penetration, 
and application of an Archimedes, an Euclid, or a New- 
ton, to contemplate as with mathematical precision, 
every iota which may reasonably be called to their aid. 
It is related of the celebrated Cheselden, that he never 
engaged in a serious surgical operation, without previ- 
ously offering up a prayer to heaven! and heaven smiled 



OF THE PULSE. 95 

on him indeed, for he was one of the greatest opera- 
tors of his age. 

Let us then ponder well, the silent eye, while it would 
reach, as it were, the labouring soul of the suffering pa- 
tient, should never lose sight of the important truth, that 
the eyes of heaven, with beams of resplendent light, 
beholds the solemn contract; and he who dares to tri- 
fle with disease, may have his name registered in the 
eternal records as the murderer of him who committed a 
life to his care. 

I have said the arteries have a power of contraction, 
in some measure independent of the heart. I mean mere- 
ly that the contractions of the arteries are not always si- 
multaneous with the contraction of the heart; on the con- 
trary, we find in palpitations of the heart, that those of 
the arteries do not beat synchronically with those of the 
heart; besides, a simple view of the blood's motion clear- 
ly shows, that the arteries possess a propelling power: 
for, the blood ascends and descends, and therefore, if 
the blood owed its jet-like motion to the stroke of the 
heart, it must vary in its rising and sinking course, but 
we find it the same; and besides we sometimes find the 
pulse different in the arms of the same patient. 

It remains to give a few directions for examining the 
pulse. 

1. It is always necessary to feel the pulse carefully 
in both wrists, and in strangers we must never forget 
that the principal artery runs on the back of the wrist of 
some persons. I have known the case of a gentleman 
and one of his daughters, having this peculiarity; and 
hence the necessity of the utmost caution, in one about 
to examine the pulse, and also of every man's knowing 
the condition of his own pulse when in health; it is obvi- 
ous that a mistake of this kind might prove even fatal, as 
we might suppose there was little or no pulse. 

2. Be satisfied that the patient is not labouring under 
any particular alarm or perturbation; and also that the 
arm has not been under any particular pressure or con- 
finement, (just then) before you examine the pulse, for 
these circumstances may materially alter the action of 
the artery. 



96 OF THE PULSE. 

3. Never make up your opinion of the pulse, without 
examining it at least twice, at intervals of a few minutes. 

4. Enjoin silence around, and by closing your eyes 
endeavour to exclude every thought; by practice you 
may acquire such a complete power of abstraction, as to 
receive as it were the very breathing of the pulse upon 
your mind. What more solemn sight, than that of the 
humane and skilful physician leaning his very soul, if I 
may so express myself, upon the struggling artery of the 
father, mother, &c; and at such a sight the host of hea- 
ven may pause, till 'judgment is given, when recording 
angels shall register the solemn act! then beware, for it 
may debit or credit you to an immeasurable amount. 

5. Apply all the fingers to the artery at once, and feel 
it under several different degrees of pressure, before you 
form an opinion. 

6. It would be a good rule to examine the pulse first 
by time, as counting the beats for a minute, or less time, 
if you have a watch beating seconds, and afterwards close 
your eyes, and examine it again. 

I have said, that in general, we cannot form much no- 
tion of disease from the frequency of the pulse alone; but 
although this is generally true, and although it is true 
also, that the number of strokes in a given time, vary 
much in different persons in health, still we may set it 
down as a fact, that a pulse low as forty beats, or as high 
as an hundred and upwards, always indicates disease; 
and when it runs as high as one hundred and thirty to 
forty, above which we cannot distinctly count it, it is al- 
ways dangerous. This is not the only advantage of as- 
certaining the state of the pulse by the watch; by it we 
may discover the intermitting pulse, for if we count, say 
fifteen strokes in fifteen seconds, and in the next fifteen 
seconds but eight or ten strokes, we discover that the 
pulse intermits. If we now lay aside the watch, and 
in the most cautious manner proceed to examine the 
pulse, by the sense of feeling alone, we will be enabled, 
by withdrawing the mind from every other subject, to 
judge of the tension, weakness, quickness, lockedness, 
of its fullness, of its smailness, and also whether it is 
shattered. But as respects these states of the pulse, we 



OF THE PULSE. 97 

can derive no knowledge from the watch, on the contra- 
ry, it may withhold the mind in some measure from a 
perfect cognizance of the case under consideration. \n 
judging of the frequency of the pulse, we must bear in 
mind, that in infancy the pulse is more frequent; seldom 
less than a hundred beats, and in disease considerably 
upwards. I have sometimes been unable to count its 
strokes, for, where it is so extreme Jy frequent, the sen- 
sation imparted to the fingers is rather a tremulous qui- 
vering motion, which distracts distinct perceptions. 

In the evening of life the pulse becomes frequent again, 
not, however, to that degree of frequency which attends 
infancy. At this period of life there is pretty much of a 
tendency to what are called ossifications of the arteries, 
and should such a thing occur at the wrist, a fatal mis- 
take might be made. A case of this kind occurred at the 
Baltimore Hospital during the late war, but the patient 
being lean, the arteries could be seen pulsating in places; 
for these ossifications were in snort pieces. I have seen 
these ossifications existing in various parts of the body; 
I have never seen any resembling bone, and therefore 
am somewhat surprised, that this incorrect name should 
be continued: they are always cartilaginous, and there- 
lore might be called hyper cartilages. Since the first 
edition of this work, I have met another case of this af- 
fection of the artery, in the right arm of a male patient, 
in the Baltimore Hospital. 



13 



OF BLEEDING, &c. 

SECTION I. 

Bleeding by the Lancet. 

BY the term bleeding, blood-letting, phlebotomy, or 
venesection, is mostly meant the taking of blood from a 
vein; other modes have been sometimes practised, as ar- 
tenotomy, or opening an artery; bleeding by leeches; or, 
scarifications, sometimes accompanied by cupping. I 
shall take them up in the foregoing order, and give such 
directions as are necessary, for the proper performance 
of those operations: the proper application of bleeding, 
in general, must be sought for in the body of this work. 

We may remark first, with respect to common bleed- 
ing from a vein, that, the intention in view, in applying 
a ligature or string about the limb, is to stop the blood 
from passing in the veins, into the body, and therefore, 
we must always apply a pressure upon the vein, be- 
tween the orifice and the body; but if we apply this pres- 
sure so strongly as to stop the blood in the arteries we 
get little or no blood, for the blood passes outwards in 
the arteries, but inwards in the veins: in bleeding in the 
arm, we always tell by feeling the pulse at the wrist 
whether our string is too tight, for if it is, there will be 
little or no pulse. 

By far the most usual mode of bleeding is at the bend 
of the arm. In performing the operation here, we are 
to apply a soft ligature, about an inch and a half above 
the place we intend to open the vein, observing first, to 
feel carefully for the artery beating, which, we must al- 
ways endeavour to avoid, should we even take a vein 
less promising: and there is also a thin tendinous fascia, 
which can be felt particularly tight, jjust under the skin, 



OF BLEEDING. 99 

when the arm is straightened; this should also be avoid- 
ed. This operation is now so generally understood, that 
I think it unnecessary to say any thing more than to 
state as my confirmed opinion, that the spring lancet is 
the safest and most convenient instrument for this op- 
eration. 

In very fat subjects, and in some few persons whose 
veins are very deep, we cannot bleed in the arm; in these 
cases we will generally succeed by immersing the hand 
in warm water, and opening a vein on the back of it. 

Persons who are liable to faint, from being bled, 
should always lie down, except the case requires that 
the patient should faint, which is sometimes necessary, 
in cases of dislocations, strangulated ruptures &c; but 
this is an expedient which is only safe in the hands of 
competent practitioners. 

It is sometimes advisable to bleed in the foot, here we 
are to apply the ligature to the ankle, and the foot must 
be immersed in warm water. Great care must be taken 
to avoid cutting immediately over a sinew, or a bone. If 
we wish to ascertain correctly the quantity of blood ta- 
ken, the foot may be taken out of the water, and the 
blood caught in a vessel as from the arm. Where it is 
thought material that we draw blood from the foot, and 
find it impracticable, we can often bleed in the ankle to 
advantage. 

Opening the jugular veins, situated in the neck, has 
also been practised in cases of apoplexy, drowning, and 
other sudden comatose cases of disease. This is an 
operation that ought not to be undertaken by those una- 
quainted with anatomy, unless there is an urgent neces- 
sity: the vein will generally rise distinctly into view, on 
a pretty firm pressure being made with the thumb, about 
the middle of the side of the neck. In performing vene- 
section here, we are to apply the thumb on the vein below 
the orifice, for the blood is passing downwards in the 
jugular veins. As an errour here might prove fatal, I 
think proper to mention that, a ligature or string tied 
round the neck, for the purpose of filling the vein, might 
prove fatal, in a few minutes in cases of disease. But 
where we find much difficulty in filling or raising the 



iOO OF ARTER10T0MY. 

vein, we may often succeed by applying, to the side of 
the neck, a little pad made of a rag folded several times, 
and tying this pretty firmly by a string brought up under 
the arm of the opposite side, and over the pad. 

SECTION II. 

Of JLrteriotomy . 

JLrteriotomy is only practised on the temporal arteries. 
When this operation is thought necessary, by examining 
about the temples, we will discover the artery by its 
beating; if the artery seems deep, it will be advisable to 
cut a little opening through the skin, this will bring the 
artery to view, and enable us to slit it open; a small 
opening will suffice. When the part has bled sufficient- 
ly we must apply a little lint, and over this a bit of lead 
or silver coin, and bind it on: should there be any diffi- 
culty in stopping the blood, the artery may be cut en- 
tirely through, as a certain means of stopping the dis- 
charge. I have practised this operation frequently on 
children who could not be bled in the veins, and also 
in some cases of adults, who were labouring under phre- 
netick affections of the head, accompanied with a fever, 
which would not bear bleeding from the arm; and beg 
leave to recommend the operation as not only safe, but 
highly beneficial, when properly applied. 

SECTION III. 

Of Bleeding by Leeches. 

Bleeding by means of leeches has been extensively 
practised in our cities, for many years, and with much 
advantage, in cases of local inflammation, of the eyes, 
and other parts; and, I think I am correct in saying, 
they are much less irritating than the rusty knives usually 
found in <• arificators, used for cupping, more especially 
where cups ire applied^ but although this is generally 
true, there are exceptions, where the more irritating 



OF BLEEDING BY LEECHES. 101 

effects of cupping makes the scarificator preferable, as in 
rheumatick affections. 

To bleed with leeches, it is necessary to cool the part 
by holding a cold wet rag for some time on it, to rab 
the part with a little cream or milk, and to put them into 
a vessel which allows them little room to move about. A 
common two ounce vial answers very well if the bottom 
is cut off with a file, and the mouth of it applied to the 
part, or a common wine glass may be used; the vessel 
in which they are applied must be filled with water.- 
Leeches are a valuable remedy, much neglected in prac- 
tice, more especially in the country. And as they are 
easily obtained during the summer, and may be kept 
over winter, I shall give some advice respecting the 
choice of them, the want of which information has, pro- 
bably, often prevented persons from using them, as it is 
generally understood that some of them are poisonous. 

It is best to get leeches from the clearest water, those 
that live* in dirty stagnated water, produce more irrita- 
tion and inflammation than those found about sandy bot- 
toms. As they are only to be accurately described by 
the use of technical language, I shall merely designate 
them by the colours, and, indeed, this is all that is neces- 
sary for practical persons: The back is of a dull green- 
ish colour; the belly a blueish ground, spotted with yel- 
low; on the back and sides are four yellow stripes, run- 
ning lengthwise, and two of these are broken in places 
with black. Those which have been objected to are 
nearly all over brown, with some dirty yellow; but even 
these have been used with safety, and, I think I am cor- 
rect in asserting, that, leeches taken from clean water 
may always be used, but for children they should not 
be too large. 

To preserve leeches, put them into vessels half full 
of water, and over the top, tie a piece of thin muslin 
or old linen. Examine the vessel once a week, and 
change the water; if any die, remove them immediately; 
keep several small vessels, so, that, they are not crowd- 
ed; and when fresh* ones are taken, or after using, put 
them into a vessel by themselves. Be careful to keep 
them from freezing, but their water should be kept cool: 



10& OF CUPPING. 

glass bottles answer well for keeping leeches in, and it 
is well known that they do not require any food. In 
general we may leave them on till they fall off, but if we 
have any difficulty, by dipping the finger in strong salt 
water, and touching the head a few times, they will let 
go. We may now either throw them into a vessel of 
clean water, or we may lay them on a smooth board, 
and while we hold down one end with a finger, we may 
strip the blood out at the other end, with a finger of the 
other hand. Should wounds made by leeches, continue 
to bleed longer than we wish, a little dry lint, pressed 
upon the part for some time, will check the bleeding; 
but in cases where we wish to promote the discharge, 
after they have come away, and which is often necessa- 
ry, the part may be well fomented with warm water. 

SECTION IV. 

Of Cupping. 

Bleeding by the scarificator and cups, usually called 
cupping: an instrument may be had for this purpose call- 
ed scarificator, in which there is usually about sixteen 
short knives, which, by means of a very strong spring, 
cut so quickly as to produce very little pain: and we can, 
by moving a slide, set the knives so as to cut deep or 
shallow, as we may choose to draw more or 1< ss blood, 
or as we may have occasion to cut over fleshy parts, or 
the contrary. Where we wish to draw some blood, in 
this way, the part is to be bathed with warm water, and 
a bell shaped glass or tin cup is to be applied, as quickly 
as possible after burning a little paper or tow dipped in 
a little spirit of wine or whiskey, in it. The cups have 
a small hole in the top, stopped with a plug or bit of wax 
which will enable us to take off the cup by giving a lit- 
tle vent at the opening. Cupping may be used to great 
advantage in cases of rheumatism, gout in the feet; in 
affections of the head, in cases that will not admit of ge- 
neral bleeding. 



OF SCARIFYING. — OF DISEASES. 103 

SECTION V. 

Of Scarifying. 

Scarifying, by means of a common thumb lancet, is 
sometimes practised to great advantage in severe cases 
of hooping cough, and other affections of the breast of 
children. It is done by making from two to four or six 
shallow cuts about an inch long, between the shoulders; 
they need not be deeper than just sufficient to cause the 
blood to flow a little. 



OF DISEASES 

SECTION I. 

Of Nosology. 

IT still remains, for some future genius, to unfold and 
explain the laws by which disease, in its varied forms, 
can be properly and safely distinguished; and until that 
happy epocha, the practice of medicine must be difficult, 
and clouded with much uncertainty. 

Whether the human race will ever reach this state of 
vast improvement, is more than I shall dare to predict 
or deny; but I feel compelled to say, that we never can 
be thus blessed, unless moral evil shall be brought un= 
der subjection. 

Many attempts have been made by men of the most 
brilliant talents to class, or arrange diseases, so as to di- 
rect us in distinguishing them from each oth^r. These 
systematic^ arrangements of diseases are called noso- 
logy* 

Other physicians, of equal talent, have called in ques- 
tion the usefulness of nosology, and have been disposed 
to simplify; some having gone even so far as to consi- 



104? OF DISEASES. 

tier diseased action, in the human body, but an unit, and 
therefore indivisible. 

It is to be lamented that such is the effect of climate, 
habit, and of vice, &c. that diseases are ever varying. 
The strong, but simple features, which characterized 
the diseases about a century since, in England, are no 
longer to be found; and, in their stead, a train of ner- 
vous affections have come upon them, which, in systems 
of nosology, amount to many hundred different diseases. 

It is also found, that the same disease is subject to 
perpetual change: a disease, which to-day is highly in- 
flammatory, may to-morrow be low, nervous or malig- 
nant. And further; even epidemicks, which extend 
over large tracts of country, or over a city, will not yield, 
in different seasons, to the same treatment. 

The yellow fever of Philadelphia, in 1793, yielded 
most readily to copious evacuations from the bowels, 
from the use of calomel and jalap; and the lancet; while, 
in ninety-eight, and some other seasons, sweating and 
vomits, and, in some cases, even laudanum was found 
ii Refill. Besides, diseases are so much influenced 

and varied in appearance from the use of medicines, or 
even regimen, that two cases cannot be found alike. 
Every person has some idiosyncrasy about them, which 
may vary their diseases. When we review all those 
things, how vain does it appear to expect any thing like 
perfect systems in medicine? 

We must admit, that nosology has done much to adorn 
and improve the knowledge of disease; but while our 
habits, &c. are constantly changing, those systems must 
be constantly varied, and this can only justly be done 
by men possessing talents little short of a Newton; and 
after all, before they could be extensively understood, 
they would no longer apply. It follows then, that noso- 
logical arrangements are only useful as a dictionary; for, 
ys a scholar cannot well be made without a dictionary, 
nor yet with it alone, so, with nosology, it will neither 
make a physician, nor can he do without it. 

In the following description of disease, I have thought 
it best to avail myself of the labours of both parties; not 
by way of compromise, but because I think a middle 



OF DISEASES. 105 

course will be most proper; at least, for a work of the 
nature of this. 

The first distinction which I shall make is, to divide 
diseases into two great classes; these are distinguished 
from the circumstance that one set arises from excessive 
excitement; and the other, from abstraction, or exhaus- 
tion. 

SECTION II. 

Of Diseases of excessive Excitement. 

To give a list of diseases, with their symptoms, in 
each of those classes, would be to compile a system of 
nosology, which I shall not attempt; because, as I have 
said in the preceding article, diseases are never station- 
ary. They change not only daily, but, in many cases, 
one hour may completely change the character of a dis- 
ease. 

Diseases of the most fixed and regular inflammatory 
cast, are principally to be found among people who live 
regularly, and in habits of industry, but more especially 
those who are engaged in the pursuits of a new country. 
They are not marked with that versatility which accom- 
panies the diseases of more polished and enervated 
people. 

Thus, for instance, a genuine pleurisy, rheumatism, or 
inflammatory fever, which are brought on healthy athle- 
tick people, by the vicissitudes of the weather, or some 
oppression, as straining or fatigue, will yield generally 
to very simple treatment. Here the skilful physician 
will bleed; and if that will not do, he bleeds again and 
again, until the disease is subdued; and when nature is 
relieved of her unwieldy load, she rapidly repairs the 
breach, and seldom requires the aid of stimuli or to- 
nicks; nor, indeed, will she often bear it, and requires 
nothing but rest, mild diet, and regular sleep. 

This state of disease is only to be found among peo- 
ple inhabiting healthy districts of country; for so essen- 
tial is a wholesome atmosphere, that the best constitu- 
tion, and the best habits, cannot secure from diseases of 
a more irregular character, as agues, bilious remittents, 
14 



106 OF DISEASES. 

and even typhus fever; all of these may be ushered in 
by inflammatory symptoms; and hence comes a difficul- 
ty in their treatment; for, if we suffer ourselves to be 
led astray by the strong full pulse, the flushed cheeks, 
or the acute pains or stitches, and reduce our patients 
suddenly by bleeding, we may produce irreparable mis- 
chief. It is true, these diseases often require the use of 
the lancet; but it can only be used by a skilful physi- 
cian. Some seasons, they bear pretty free evacuations 
by bleeding; in others, we must be contented with such 
medicines as operate on the bowels. 

It may be objected that typhus can never require the 
use of the lancet; but who has not seen a complete ty- 
phus transformed into a fever, really inflammatory, and 
requiring a corresponding treatment. 



SECTION III. 

Of Diseases of Abstraction. 

In taking a view of this grade of disease, we are not 
to suppose in all cases, sensible expenditure has taken 
place; nor that there is not inordinate action somewhere; 
but it is generally found in other parts of the system than 
those which are the seat of inflammatory ones, manifest- 
ing itself, in the nervous or sensorial system. 

This form of disease is occasioned by the gradual loss 
of animal powers, from intemperance; and from the va- 
rious debilitating habits of the artizan, recluse, or stu- 
dious; and sometimes suddenly by a pestilential atmo 
sphere. 

Under this head, we may notice first such diseases as 
are the consequence of actual abstraction, as loss of 
blood, want of nourishment, or want of air, &c. all of 
these may terminate in death; but these causes produce 
the most simple diseases of this class, and seldom re- 
quire much from medicine; a wholesome air, mild nou- 
rishment and rest, are principally necessary; and it is 
truly astonishing how far those things may be borne with- 
out disorganization, or congestion. But where these and 
other causes operate very slowly for a length of time, they 



OF DISEASES. 107 

impair, or deprave the fluids, and this leads to conges- 
tions and disorganization, the destroyers of animal life. 

Here we may next notice, a still more insidious form 
of disease, arising from exposure to a pestilential air. 
Such air is often found in crowded camps, jails, &c. and 
sometimes diffused through the atmosphere generally. 
These deleterious gases act with such a tremendous 
force, as to hurry the system in a few hours through a 
violent inflammatory stage, and then prostrate the sys- 
tem below a healthy action; or what is more common, 
rapid exhaustion, or locking up of the vital powers, 
prostrates the system at once to a most dangerous de- 
gree, and often expends the living principle so far, or 
at least, so completely fixes it on a particular part, as to 
leave nothing for medicine to act upon. 

This form of disease has generally got the name of 
putrid; but no such thing as putrifaction can exist in a 
living body; this is a property belonging to dead matter 
only. It is true, disease often approaches to the very 
verge of it, but still, any thing like putricency in the fluids, 
is wholly incompatible with life, and therefore this term 
ought to be exploded. The term malignant is sufficient- 
ly expressive, without conveying false ideas. 

Another form of disease exists, the consequence of 
idleness and intemperate habits, such as necessarily, or 
viciously attach to refined society, as want of exercise, 
too cordial and gluttonous diet, sedentary employments, 
drunkenness, want of reasonable sleep, avarice, intense 
study, &c. This form of disease, has got the name of 
nervous, and the name is sufficiently expressive. 

The symptoms of this class of nervous diseases are 
numerous beyond calculation; the various combinations 
of them has given rise to large systems of nosology; and 
after all, no two cases can be found precisely alike. 

But amid all this variety and confusion, we have con- 
solation in the knowledge of their causes, which may 
often be avoided; and in knowing that they are all bot- 
tomed on constitutional debility, and require tonicks 
adapted to the state of each case. They may be miti- 
gated for a short time by stimuli, but permanent relief 
can only be expected from the avoidance of their causes^ 



108 OF EPIDEMIC Kb* 

the use of tonick, exercise, and a proper regimen; and, 
the use of stimuli will lead to greater evils. 

We are naturally led to these conclusions, that al- 
though disease is essentially but twofold, that still we 
gain but an imperfect knowledge of them without fur- 
ther distinctions, for, so rapidly do these opposite states 
succeed each other, and so much is morbid action influ- 
enced by peculiar circumstances, that we can only obtain 
a reasonable knowledge of them by seeking their causes^ 
and classing their characteri stick symptoms. 

And, although it be really and undeniably true, that all 
our remedies both medicinal and regimentous, operate 
either by reduction and lessening action, or by repletion 
and imparting action and tone; yet it requires an inti- 
mate acquaintance with the laws of the animal economy, 
with the causes of diseases, and with the nature, or 
respective force or strength of each article of medicine, 
&c. to enable us to prescribe with success, or sometimes 
even with safety. 

With these general observations, I pass on to what I 
consider the next necessary tlivision of our subject, and 
shall divide them into epidemick, endemiclc, contagious, 
fortuitous, and habitual diseases. It may be necessary 
to premise, that these are often blended in such a man 
ncr as to render it difficult to class them, or to detect 
their symptoms in each individual case; but much use- 
ful knowledge can be had from proper attention to those 
distinctions. I am aware, that objections may be made 
to tiiis division of diseases by the critick, but after much 
reflection, I think it the most proper in a work of the na- 
ture of this, it having a tendency to lead the mind to use- 
ful practical distinctions. 

SECTION IV. 

Of Ejpidemicks. 

These are diseases which arise from causes indepen- 
dent of the sensible qualities of the weather; and per- 
vade whole districts of country, or cities. Of this class 
no one has been spread so extensively as the influenza. 



OF EPIDEMICKS. 10 4 J 

In the United States, we are subject to yellow fever, 
bilious remitting fever, influenza, typhoid or low fevers, 
measles, hooping-cough, scarlatina, or malignant sore 
throat, and perhaps some others. 

Although epidemicks in general, are under regular 
laws which confine them to certain districts of country, 
and seasons of the year, still they are found to be influ- 
enced by circumstances, as the habits of the people, the 
weather, the climate, and by an influence they have upon 
each other. Of all these particulars we have some know*- 
ledge, but it is very imperfect. 

Thus on a delicate people, glandular and nervous af- 
fections will be found predominant; while on a people 
of firm stamina, and athletick habits, they seem to ope- 
rate most conspectably on the muscles and fluids of the 
body; and when left to themselves terminate mortally, 
more suddenly than the same disease on the delicate; 
but are much more easily managed in mild climates by 
proper remedies. 

It is manifest that the weather has influence on epide- 
micks, for, although sporadick cases of yellow fever oc- 
cur during winter; as an epidemick this disease never 
fails to yield to the killing frost of fall. 

Climate is known to vary the character of epidemicks; 
the yellow fever is more rapid in its progress in warm 
climates, and requires a more prompt treatment, while 
large districts of country are found where yellow fever 
never existed. 

Epidemicks have an influence upon each other; for 
we seldom see two epidemicks prevailing at the same 
time; two of great force are never found together; so 
much do the more alarming epidemicks affect all around 
them, that chronick and habitual diseases are affected by 
them. Here it may be remarked, that it is a pretty ge- 
neral law in nature, that two diseases shall not exist in 
the same subject at the same time; but there are excep- 
tions; so are there exceptions to this law of epidemicks. 
From the foregoing view of epidemicks we may draw 
a few practical remarks. 

Has an epidemick been discovered in a neighbour- 
hood; and distinctly characterized, it behooves every per- 



110 OF EPIDEMICKS. 

son to become scrupulously temperate, but not too ab- 
stemious; avoiding all excess in eating, drinking, exer- 
cise, exposure to night dews, curbing closely the pas- 
sions, and avoiding every sensual indulgence; for, when 
the atmosphere is loaded with the seeds of an epidemick, 
any irregularity may excite the prevailing disease. But 
it must not be forgotten that all extremes meet in the same 
point; and not to exercise at all, or, to live very much 
below your healthy standard, will be as prejudicial 
as an opposite course, and therefore must be equally 
avoided. 

Should disease come on, notwithstanding your care, 
your precautions will not be lost; for, in ninety-nine 
cases of an hundred, the disease will be milder for it; 
and if not, it will be a precious cordial, when brought 
low r , to believe you have done your duty, and have not 
directly had any agency in bringing on the disease: such 
reflections will inspire you with confidence in Him who 
ruleth. 

It is now your duty to call medical aid; if it is not 
obtainable in reasonable time, you will often be in pos- 
session of knowledge of the suitable remedies, from 
knowing what was prescribed by medical men in your 
neighbourhood; but never let this prevent your getting 
advice. If you have no such information, you can ne- 
ver be wrong in remaining quiet, and opening your bow- 
els freely with injections; but for other remedies, I must 
refer to the treatment of each disease. 

By keeping your view on the fact that all diseases do 
homage to powerful epidemicks, you will be enabled 
sometimes to discover at an early stage of an attack that 
it is nothing but the prevailing disease; and if you are 
subject to habitual disease, may prevent you from doing 
irreparable mischief; for the epidemick may be very dif- 
ferent, in its nature, from your habitual disease. These 
observations apply principally to yellow fever, remittents, 
and typhus fevers: the other diseases, of the class of 
epidemicks, are either more marked in their character, 
or less dangerous; and therefore I shall refer my obser- 
vations on them to my catalogue of diseases. 



OF ENDEMICKS. — OF CONTAGIOUS DISEASES. Ill 
SECTION V. 

Of Endemicks. 

This class of diseases are so similar to that of epidem- 
icks, that I shall have but few remarks to offer concern- 
ing them. They are such as are confined to place, and, 
like epidemicks, are occasioned by an unwholesome ah\ 

The most prevalent diseases of this class are agues, 
and remittents: yellow fever, and dysentery, may be pla- 
ced in either class; or, perhaps, more correctly speaking, 
epidemicks and endemicks are one and the same thing: 
the former, being a more diffused, and the latter a more 
local disease. It follows, that the same precautions and 
views apply to both. 

It will not be out of place to observe, that as epidem- 
icks are influenced by climate, and occasioned by a con- 
taminated air, it becomes the duty of all, who conve- 
niently can, to remove to some healthy place. We fly, 
at the risk of every thing, from before victorious armies: 
and are we not equally bound to flee from disease? Thou- 
sands of lives might be saved in this way. It is the 
duty of the medical profession to warn the people; not, 
however, without good ground; and it becomes the reli- 
gious duty of every physician to stand his ground: he who 
flees at such a time, is unworthy his profession and of 
the people's confidence. 

ECTION VI. 

Of Contagious Diseases, 

There is strong grounds for believing that there is but 
one contagious disease affecting mankind, and for that we 
have been blessed with a certain prophylactick. I shall 
not undertake to say, whether this boon was reserved for 
the age that put down the slave trade, and who are car- 
rying the light of the gospel to all nations and tongues; 
but surely it is a pleasing coincidence, and leaves hope* 



11& OF FORTUITOUS DISEASES. 

that similar blessings await our virtuous deeds, should 
they continue to wax greater. 

This terrible scourge knows no dictinction; he dwells 
in the air, and in the body; from pole to pole, the great 
or small, black or white, nor age, nor sex, just or unjust, 
are exempt from its ravages. The sandy deserts or 
flowery valleys, the heathen and the christian, all, all, 
feel this domineering scourge; neither winter nor summer, 
nor temperance, can restrain his wrath. 

But a benevolent God, to christian man revealed the 
long, long, hidden secret, which on wings of charity, 
traversed the world with a speed, which no former age 
could have equalled; and entails on mankind a blessing, 
which forms an important era, and probably will go far 
to spread Christianity; for to the heathen was given a 
Bible in one hand, and this blessing in the other! 

I believe then, that this is the great seal on contagion, 
and that it only remains for man to live rationally, and 
the day will arrive when the word contagion shall cease 
to be known. 

I am not disposed to enter into any critical explana- 
tions of contagion, but I am confident if my opinion is 
not correct, it is not mischievous, and that all diseases will 
arrange properly under that of fortuitous or epidemiclcs* 
which have been usually considered contagious. 

SECTION VII. 

Of Fortuitous Diseases. 

Under this head, I shall take occasion to warn the un- 
skilful of the difficulty of acquiring a medical knowledge, 
and ot the danger of tampering with disease. Here is 
opened a multiplicity which bewilders and should con- 
vince us, that the Creator has intended man shall not fix 
his eyes exclusively on this world. 

Every part of the body, solids and fluids, and mind, 
are all iuvaded by diseases which we can neither trace 
to their causes, nor reduce to system, because they are 
ever varying with circumstances. The active and idle, 
the strong and weak, the male and female, infancy. 



OF HABITUAL DISEASES. 113 

youth, and years of maturity, have all their peculiar 
diseases. And as many of these assail us without any 
premonition, how difficult must it be to arrive at a know- 
ledge, of them, which shall justify us in prescribing 
where errours may be fatal, and can never be innocent. 

Many of the diseases which I shall place in this class, 
may be avoided in our present state of knowledge; and 
the most of them are the offspring of vice or inattention. 
Thus for instance, a venereal gonorrhoea, or lues venerea, 
itch, and other diseases, are the offspring of vice, or filth; 
and the two former can only be gotten at the expense of 
virtue. 

A rheumatism, pleurisy, or simple imflammatory fever 
are most generally owing to rash exposures to the vicis- 
situdes of the weather, or inattention to suitable cloth- 
ing, or exposure to the cold dews, after the fatiguing la- 
bours of the day. 

Again, the colick and hundreds of nervous diseases, 
are occasioned by intemperance or enervating habits. 

Consumption, the greatest scourge of our country, is 
evidently often owing to neglected colds, or other slight 
diseases; or it may be excited by inattention to exercise^ 
and to the want of suitable care in our apparel. 

An attempt will be made in the proper place, to class 
and explain those diseases, and sufficient directions will 
be found for their treatment, so far as may be necessary 
for the heads of families. 



section vm. 
Of Habitual Diseases. 

Many of the habitual diseases arise out of the fortui- 
tous, and I have called them habitual, because by cer- 
tain associations, existing in some constitutions, they re- 
cur at regular or irregular periods. As an example, I 
will take asthma; this is often the consequence of some 
fortuitous disease; but, when once formed, recurs from 
various exciting causes, as fatigue, damp weather, &c. 
and having spent its force in a term of days, goes off, 
and leaves its victim free from disease, for a period un- 
15 



114 SUMMARY OF GENERAL 

certain in duration. Gout and piles are strongly marked 
diseases in this class. There are many others, which 
will be noticed in place. Some of this class of diseases 
merely lurk in the body, others are always present and 
distressing. It may be remarked here, that this class of 
diseases are often hereditary; and when severely and tho- 
roughly established, should be considered a bar against 
marriage. 

What a miserable prospect must a man or woman 
have, who enter into the married state affected with dis- 
ease, which may descend to their posterity, and some of 
which may even be communicated to their partner! Such, 
we know, is the case with yaws. This disease, like 
most others, is originally fortuitous; but may become so 
fixed as to be habitual. 

Should people inconsiderately, or unknowingly that 
they have a lurking disease, enter into matrimony, it is 
their most sacred duty to try to lessen the predisposing 
causes of disease, to which their children may be expo- 
sed; for this purpose a healthy country residence should 
be chosen, and habits of the strictest temperance formed; 
and if they are too feeble to pursue the healthy employ- 
ments of agriculture, never put them to sedentary em- 
ployments, unless absolute necessity compels; for, by 
aiding them to exercise constantly, yet moderately, they 
may acquire, eventually, strength to enable them to throw 
off their disease by good habits and active industry. 

SECTION IX. 

Summary of General Observations on Diseases. 

I have said, that however varied in grade, form, or 
symptoms, the diseases of mankind may appear, and 
however much disposed to change from one form to an- 
other, still there is but a twofold essence in morbid ac- 
tion. 

There is either inordinate action or high excitement; 
or, there is feeble, hurried action, or want of excitement 
or exhaustion. 



OBSERVATIONS ON DISEASES. lift 

I have also said, all extremes meet in the same point; 
thus, where stimuli act with great excess of force on the 
hod y, instead of rousing up strong action, they bear 
down every energy; and instead of powerful action, we 
have scarcely any action at all. But, notwithstanding 
this deceptive appearance, such cases belong to diseases 
of oppression, and require the abstraction of stimuli 
from the body, by bleeding, purging, emeticks, &c. to 
relieve nature from a part of the load, and reaction 
comes on, and nature points out more clearly the real 
nature of the case, and enables the physician to judge 
how far he must deplete. 

On the other hand, debilitated persons, either consti- 
tutionally so, or from the slow, continued debilitating 
effects of unwholesome air, &c. when seized with dis- 
ease, nature, as if suddenly alarmed, rouses up a hur- 
ried, excessive action; and if we were to judge by the 
pulse alone, we should, most certainly, think such a 
case partaking of high inflammatory action. 

But this would be an egregious mistake; for, if we 
were to deplete in such a case, death or great danger 
would certainly follow. This state of the system being 
really the opposite of a disease of oppression, is properly 
called a disease of abstraction or exhaustion; and the 
sudden sally which nature makes, apparently powerful, 
is slightly bottomed; and to prevent her from expending 
the energies of the body in those transient efforts, we 
must apply stimuli, and endeavour to accommodate them, 
in quality and force, to the state of the system. 

The first case may be compared to the mighty oak, 
borne down by the hurricane; when the wind ceases, it 
rises, not only to its proper position, but, by reaction, is 
carried beyond it. But, if the wind cease not, or be- 
comes too powerful, with one fatal sweep down goes all 
hope. With how much success may we operate against 
such a force, by strong efforts, in an opposite direction? 
A tree secured, may be saved from the fatal storm; so 
the skilful physician, by opposing nature, removes the 
disease. 

The opposite state of the system bears some simili- 
tude to a sickly plant wanting light: it grows rapidly; 



116 SUMMARY OF GENERAL 

but if the light be not admitted, in makes an unavailing 
effort, and then sinks and dies; but if, in due time, light 
be admitted, it stimulates, and raises new action, and 
health and vigour follows; so with the exhausted pa- 
tient: infuse suitable stimuli into his languid system, 
and he recovers tone and vigour by degrees. 

Still, such is the variety of the causes of diseases, and 
so much are they governed by present circumstances; 
so rapidly do they pass from one form to another, and so 
difficult is it to appreciate or apply remedies, suited in 
form to either state of the system, that we are obliged to 
class or group our diseases and remedies to enable us, 
with more success, to trace morbid action, and expel it 
from the body. 

When we trace diseases as epidemicks, we find them 
spreading through a whole country, and producing, not- 
withstanding every peculiarity of habit and circumstan- 
ces, in the main, a train of symptoms and consequences 
nearly alike. This enables us, when we have disco- 
vered a suitable treatment for the present season, to pro- 
ceed with much greater ease and success, and by know- 
ing our liability should induce us to be more careful 
in our habits; but still there is always such variety as to 
call for the attention of the most skilful physicians. 
We often have it in our power to flee from epidemicks; 
it is our duty to do so. To some of these we are ob- 
noxious but once in life. 

When we examine diseases, as endemicks, we find 
them nearly resembling epidemicks; but have it still 
more in our power to shun them, because they are lo- 
cated, and are often brought on by intemperance, fatigue, 
&c; and because it is often in our power to remove 
from them, or lessen the remote causes, which are 
effluvia arising from decaying vegetable and animal 
matters; by draining ponds and marshes, by cutting 
down weeds, &c. and removing them to a dry place, 
or burning them, &c. 

When we view diseases as contagious, we are hum- 
bled, indeed, to think that a bounteous Creator has ren- 
dered us obnoxious to diseases, against which no efforts 



OBSERVATIONS ON DISEASES. 117 

can avail; neither climate, morality or immorality, Chris- 
tianity or paganism, cleanliness or filth, nor naught in 
neat ion can prevent or restrain! Such was the smallpox; 
but I feel happy in the belief that the vaccina will some 
day remove this ungovernable scourge from the list of 
of our diseases, and that we now have it more com- 
pletely under subjection than any other disease. 

Oh! man, if thou canst appreciate the bounteous gifts 
of Heaven, rejoice that this fell destroyer is chained from 
those who accept the cheap, cheap, proffered favour of a 
benevolent God! And have you neglected to secure your 
children? Let not the shades of night over-shadow thee 
till the good deed is done; for this blessing has gone out, 
hand in hand with the Bible, to all tongues and nations; 
and wilt thou alone dare thy God to inflict upon your 
children that which he has ordered to sleep, with the 
blindness of the heathen? Can you dare to survey the 
pretty face divine of your child, and deny it a favour for 
which it might justly despise you? 

When we turn our attention to fortuitous diseases, 
we see a necessity for further distinctions; they amount 
to a very great number; but it may be said of them that 
they are more the consequence of our own inattention, 
kc. than any other class of diseases; and the causes of 
many of them being known, we have it in our power 
often to prevent them. 

By suitable inquiry into habitual diseases, we may ac- 
quire a knowledge of our own constitution, and often be 
enabled to prescribe for ourselves, with that promptitude 
which is often necessary, without the advice of a physi- 
cian; thus the asthmatick might suffocate before medical 
aid could arrive, unless he is able to prescribe for him- 
self; and if he do nothing but admit a current of fresh 
air, still it is a remedy, and implies a belief that the pa- 
tient has some knowledge of his situation. 

It may also enable him, by extraordinary care, to 
keep down diseases, which he knows are hereditary, 
and were existent in his parents. 

Having now premised with these general observations 
of diseases, and of the general intentions in view, in re- 



118 OF THE YELLOW FEVER, 

moving or obviating them, so far as I think they will be 
found useful, I shall pass on to treat of each individual, 
to which we are most exposed in this country, and ar- 
range them, so far as practicable, on the plan laid 
down. 



OF EPIDEMICKS INDIVIDUALLY, 



SECTION I. SUBSECTION I. 

Of the Yellow Fever. 

x HIS has been known to prevail in the cities of the 
United States, at considerable intervals, more than a 
century. In Philadelphia it has been publickly acknow- 
ledged in the years 1099, 174t, 1762, 1793, and to a 
considerable degree, in several years since. All of our 
cities have sometimes felt its effects. It is a very great 
errour to suppose that it is confined to cities; it has pre- 
vailed in many parts of the country, with a mortality 
equalling any thing we have seen in our cities. 

Sometimes it has appeared as an epidemick; and spo- 
radick cases of it are to be found in every place where 
bilious remittents are rife. 

The most certain guide for those unacquainted with 
its symptoms will be a knowledge of its prevailing; for 
where it prevails as an epidemick, or endemick, other 
diseases are seldom found. It affects all ages, sexes, 
and colours. 

The dreadful mortality with which it has prevailed 
at different times, most clearly points out, not only the 
necessity which there is for every person to have some 
knowledge of its character, &c. but evidently makes it 
the duty of all to acquire a reasonable knowledge of it, 
for the following reasons. 

Although the cause of this disease is well known to be 
a tainted asmosphere, still, it is equally well known that 



OF THE YELLOW FEVER. 119 

its exciting causes are various. Intemperance, fatigue, 
exposure to night, and morning and evening air, are some 
of its most common exciting causes. 1 mean here, that 
many persons, who breathe the vitiated air, and have the 
seeds of yellow fever lurking in the body for weeks, often 
escape an attack of fever by avoiding fatigue and irre- 
gularities. 

Of how much importance then must it be to be enabled 
to spare physicians from the extraordinary fatigue and 
anxiety of mind, exposure to night air, &c? this can on- 
ly be done by people possessing a knowledge of the dis- 
ease; and with the reasonable aid of the physician, at 
reasonable hours, do that for themselves which may 
otherwise be frustrated altogether, by loosing their phy- 
sicians. 

Doctor Rush informs us, that from 1793 to 1801 a pe- 
riod of eight years, "the graveyards of Philadelphia 
contain the precious relicks of three and twenty physi- 
cians, who have died martyrs to their affectionate and he» 
roick sympathy," for people affected with yellow fe- 
ver. 

Many of the most observant physicians have noticed* 
that yellow fever most frequently attacks at night, or very 
early in the morning; and hence the advantage of each 
individual having some knowledge of, at 'least some first 
powerful remedy, that the disease may be taken in its 
forming stage. 

Besides, where this disease domineers terribly, many 
or all of the physicians may be unable to attend, and un- 
der the greatest advantages, there may be so many pa- 
tients as to render it really impossible, to get even the 
advice of a physician in time. 

Impressed with the importance of these remarks, I 
think it unnecessary to offer any apology for giving the 
publick an abstract from a history of the disease, as it 
prevailed in Baltimore in the year 1794. This excellent 
account of the fever of ? 94, is taken from the Medical 
Museum, and was written by Dr. Drysdale. 

It is the best account of the disease I have at com 
mand, and lays down a practice, rational, learned, and 
correct; and as I have become a citizen of Baltimore* I 



l&G HISTORY OF THE YELLOW FEVER 

have chosen to give it the preference.* I have only to 
request my readers in the most solemn manner not only 
to read it, but study it, commit to memory. I have thought 
proper to point out all words and sentences, which I deem 
particularly important, by a single comma, before and 
after such words and sentences, and hope thereby to take 
the attention of the unskilful, to what is most necesary to 
be known. 

This account is written in the form of letters, to Dr. 
Rush; and while it does credit to the author's medical 
talents, is strongly marked with the traits of a benevo- 
lent feeling heart. 

SUBSECTION ii. 

Letters from Dr. Drysdale to Dr. Rush. 

"Dear Sir, 

You have requested a history of the yellow remitting 
fever, as it prevailed in Baltimore; and I have perhaps 
inconsiderately promised to gratify your wish. The dif- 
ficulties which necessarily accompany such a task, in- 
crease in number, as I travel in imagination through the. 
region before me. "Hills peep o'er hills, and Alps on 
Alps arise," when I contrast them with the powers of 
my youth; I am almost dissuaded from the attempt. But 
I now enter on the undertaking with this pleasing re- 
flection, that you will indulge the deficiency of execu- 
tion, where the critick would condemn, for I am convin- 
ced with Dr. Moore, "that those who have the greatest 
knowledge in their profession, are best acquainted with 
its uncertainty, and most indulgent to the mistakes and 
errours of others." 

"An account of the weather which preceded the ap- 
pearance, and accompanied the progress of this awful 
disease to the close of its career, will be given more pro- 
perly in another place. 

*It may be remarked of the yellow fever of '94, here treated on, 
that the disease, and the treatment found most useful, corresponds 
very precisely with that of the fever of '93, treated of by Dr. Rush, 
who triumphed that season over all opposition. 



GF ? 04, AT BALTIMORE. l&l 

"But it may not be unnecessary to mention here, the 
principal diseases which characterized the summer and 
autumn. In the town the cholera made its appearance 
among children as early as the months of April and May, 
hut it is very remarkable, that this disease was unknown 
through the summer upon FelPs Point. On the lower 
part of Baltimore, the month of May was unusually 
healthy, a catarrh only affecting children. In the begin- 
ning of June, intermittents and dysenteries became more 
general, and as the season advanced, remittents also made 
their appearance. These three diseases, especially the 
first and last, ranged through every part of the country, 
and infested even the highest grounds. 

"•The most remarkable disease was the natural small- 
pox. It appeared very early in the summer, and soon 
became epidemick. It advanced with the year, and 
made such devastation among its unfortunate victims, 
that Baltimore perhaps never before experienced so se- 
vere a scourge from this disease. Even they who were 
innoculated in the spring, required peculiar attention; 
for it was so unusually insidious, that many unexpect- 
edly suffered from its malignity. 

"The first case ot yellow fever that I saw, was on the 
7th of August. The patient was in the fourth day of 
the disease, and had been harassed several hours with 
the vomiting of that dark fluid, so greatly resembling 
strong coffee, muddy with its grounds. His eyes had 
been very red but were now, together with the skin, yel- 
low; the latter was dry and cool; his pulse was slow and 
full. He was either oppressed with stupor, or deranged 
with a mild delirium. In a few hours he was dead. I 
could not pause a moment in believing his disease to be 
the yellow fever. I mentioned freely what I had seen, 
and expressed my apprehension that this case might 
prove the prelude of a scene of calamity. The Point 
was now becoming sickly, and many deaths occurred 
there suddenly, or after a very short indisposition. 

"The several deaths which had occurred, together 
with the report, that the yellow fever had made its ap- 
pearance, excited alarming apprehensions in the minds 
of the people; an inquiry was consequently made by 



122 HISTORY OF THE YELLOW FEYEK 

three of the most respectable physicians, into the siate of 
the health of Baltimore. On the fifteenth of August, 
they reported, that 'conformably to a request made by 
the grand jury, we yesterday proceeded to inquire into 
the grounds of a report, which for some days past had 
created very serious alarms among the inhabitants of this 
town, viz. that the West India yellow fever did prevail 
very generally at FelPs Point, and was accompanied with 
its usual mortality: that there are no grounds for believ- 
ing that the yellow fever is among us. 

" 'After a careful examination of several persons, con- 
fined with fevers, and the most minute inquiry respecting 
those cases, which have lately proved mortal, we are 
unanimous in the following conclusions: that the pre- 
vailing fever of that place is the common epidemick of 
the season, which annually visits our southern states, viz, 
the bilious remitting fever: that the late mortality at that 
place, which had been greatly exaggerated by report, 
has not been owing to any one class of diseases in par- 
ticular; that during the late very hot weather, most of 
the sudden deaths arose from accidental causes. Many 
of the labouring class of the people were destroyed by 
the extreme heat of the sun, while employed in their 
usual labours. 'Intemperance was the cause of death 
to some, whilst indiscretions of different kinds proved 
destructive to others.' 

" "On the whole, we are of opinion that the mortality of 
this season has not exceeded that of many former ones, 
which passed unnoticed, &c. &c. 

Signed by Doctors 

GEORGE BROWN, 
JOHN COULTER, 
LYDE GOODWIN/ 

"Every funeral recalled to the minds of the Ealtimo- 
rians, the late calamitous situation of Philadelphia. With 
the hearse and the grave they invariaby associated the 
idea of yellow fever, which had destroyed so many thou- 
sand citizens of a rival city. 

"It is, therefore, not wonderful that an alarm should 
have been excited disproportionate to the mortality that 



OF '94, AT BALTIMORE. 123 

had yet occurred. The agreeable assurances they had 
just received, (and I am confident that the physicians 
who gave them had not met in their search a single e 
of yellow fever.) calmed the apprehensions of their minds. 
It is, indeed, to he deeply lamented, that any subsequent 
misfortune should have broken this tranquil situation of 
the town. 

"On the fourteenth of August, Master M'C , (who 

lived on Bow ley's wharf, in the store with the gemle- 
man who died on the seventh,) became diseased He 
recovered from his fever: hut on the nineteenth, a yel- 
lowness was very observable over his body, and soon 
became as intense as in jaundice. On the morning of the 
twentieth of August, Mr, M n called on me for ad- 
vice. On the first evening of his disease, I suspected 
the real nature of his fever, and did not hesitate to men- 
tion my apprehensions. I attended this gentleman in 
company with Dr. George Brown, my former preceptor 
iu medicine: a person who truly comhiues all the merits 
of a professional character, with all the endearing and 
respected virtues of a gentleman. Mr. M e was at- 
tacked on the morning of the twenty-second: Mr. A. on 

the evening of the same day: and Mr. A n on the 

following morning. These four gentlemen were engaged 
in commercial business on the same part of Bowley's 
wharf. Some other persons, living at the same place, 
were also diseased at this time, but they did not fall 
under my observation. 

"The peculiar symptoms attending the fever of Mr. 

M n, from its commencement to its fatal close, called 

from Dr. Brown an unequivocal declaration of its nature. 
His apprehensions were increased by the occurrence of 
the other cases at the same time, and at the same place. 
The declaration which I had made near three weeks be- 
fore, was now seconded by an authority of the most in- 
disputable nature. A town meeting was iu consequence 
summo'ied, which terminated in the nomination of a com- 
mittee of health. Their chairman, Gustavus Scott, esq. 
was a gentleman of the highest honour and integrity; and 
it i«, therefore, to be regretted that his necessary avoca- 



1S& HISTORY OF THE YELLOW FEVER 

tions from town soon took him away from the regulation 
of their conduct through the scenes that followed. 

"Fell's Point was now becoming very unhealthy, and 
many cases of disease had terminated there speedily in 
death. On the thirty -first of August I visited, with Dr. 

Allender, Mr. I r, in the seventh day of his disease. 

He had now a constant hiccup, and copious vomiting of 
the coffee-grounds; his eyes were very yellow; his skin 
cool; his pulse full, but so irregular as to beat sometimes 
three pulsations in one sixth of a minute; sometimes fif- 
teen in the same period of time. He died the next morn- 
ing. On the same part of Baltimore I attended, with 

Dr. Brown, Mr. Thomas L , who was taken ill on 

the twenty-sixth of August: his apprentice boy on the 
twenty-seventh; and his maid servant on the thirty-first. 
Mr. C ? s son Thomas was attacked on the twenty- 
eighth; himself and his son Robert on the following day. 
A boy of Captain J ? s was attacked on the twenty- 
seventh. In the town three persons, who had contracted 
their fever on the Point, came under my observation ou 
the tWenty-ninth and thirtieth of August. All of these 
cases except one, terminated favourably. 

"While this scene of distress was extending on the 
Point, the town became unusually healthy. Some took 
advantage of this circumstance to oppose the assertion 
that a yellow fever had appeared among us, and to ridi- 
cule the authors of such a declaration. But the disease 
soon extended itself so widely that incredulity ceased, 
and even the tongue of calumny was almost silent. 

"About the sixth of September, the healthy tranquillity 
of the town of Baltimore was again ruffled by the return 
of remitting fevers, which, together with the intermittents 
of the season, were almost universally accompanied with 
catarrhal symptoms. The tenth of this month will long 
be remembered by the inhabitants of Baltimore, as the 
day which deprived them of Mr. Stephen Wilson. He 
died of a bilious colick. His unshaken patriotism as a 
citizen, the rectitude of his conduct as a great commer- 
cial character, the liberality of his soul as a humane and 
virtuous christian, the dignified simplicity of his man- 
ners as a man, and the sincerity of his heart as an inesti- 



* OF *94, AT BALTIMORE. 125 

inable friend, have left on every heart an impression 
which can wear away only with life itself. 

"The yellow fever continued to increase on the Point, 
in extent and malignity. 'Doctors Allender and Richard 
Griffith, and Degraffenreidt, were at the same time in 
imminent danger of falling victims to it. Doctor Dorling 
had lately died in town, and Doctor Griffith, Senr. on 
the Point, was carried off after thirty hours indisposi- 
tion/ The Reverend Mr. Beeston, of the Roman Ca- 
tholick church, who had been much engaged on the 
Point in administering the last offices to the dying, was 
now dangerously ill So great was the number of the 
sick about the twenty-fifth, that Doctor Coulter visited 
and prescribed for more than a 'hundred and twenty' 
patients daily. 

'•Before the close of September, a panick spread 
through the town, and drove a great number of families 
to seek refuge in the country. As I rode, on the morn- 
ing of the thirtieth, through the Point, I was struck with 
the melancholy change induced by a very few days. 
The streets were no longer crowded and noisy with bu- 
siness or festivity. The eye would scarcely meet a do- 
zen citizens in its longest streets. In the rooms of the 
sick, I more particularly observed the stillness of the 
streets. 

But a little time before, even when the reduced vio- 
lence of disease would have permitted them to doze, 
every slumber was broken or banished by the noise 
without. The whole day resembled in silence the hours 
of night. 

"A happy change of weather at this time, checked 
the rapid progress of the fever, and rescued the town 
from sharing the general misfortunes of the Point. The 
disease declined, and by the middle of October the health 
committee closed the account of the dead. The citizens 
returned to their homes and business, and in a very short 
time a person passing through the Point itself, would be 
reminded of its situation only by observing in some 
alleys the bodies of a number of dead cats. 

"I have been, sir, as concise as possible in the prece- 
ding observations. To have a more enlarged view of 



186 HISTORY OF THE YELLOW FEVER: 

our situation, while the mind was assailed on the one 
part by the actual representation of disease and mortali- 
ty, and supported on the other by the wish and assur- 
ance, that our fears beheld the occurrence through a 
magnifying glass, you must only submit to the guidance 
of memory, while she bids the misfortunes of your own 
city to glide before your imagination. The retrospect 
will remind you of that principle of the human mind T 
which subjects our senses to our wishes. The eye is 
unwilling to behold a scene that gives certainty to our 
apprehensions of misfortune; and we prefer lingering in 
a state of suspense, (so tormenting on every other occa- 
sion,) to an absolute knowledge of our situation. Hope 
soothes an uncertainty, but deserts us when convinced; 
We can scarcely believe what we wish to be untrue: so 
powerful is this principle, that as you must have fre- 
quently observed a person while hanging over the body 
of a deceased friend or relation, cannot form an idea that 
it is dead. 

' Hence, sir, it was long before our citizens could 
shake off their fancied security, by believing the exist- 
ence of danger. But when the charm was dissolved, 
the panick spread like electricity, from mind to mind. 
'Now too late, it was remembered that the dictates of 
reason had been lulled to rest, and truth had been heard 
but opposed, ridiculed, condemned!' Adieu." 

Letter second. "We have hitherto, dear sir, travel- 
led only round the borders of our subject. We will 
now. if you please, take a nearer view of the disease, 
which, although neglected and despised for a time, at 
length struck the souls of our citizens with anxiety and 
t err our. 

"The yellow fever as it appeared here, tended natu- 
rally to death. A fatal case, therefore, will portray more 
strikingly its form. 'The eye of the physician entering 
the chamber of the sick, would be arrested by a counte- 
nance of distress; the countenance of one weeping with 
the anguish of a broken heart. He would behold a face 
suffused with blood; an eye red, watery, half closed 
and sad: the parts immediately around it swoln: its si- 
lent glance spoke sensibly to the soul, and seemed to de^ 
u] and its pity. He would find the tongue moist, and 



OF *Q% AT BALTIMORE. 127 

white or clean. His hand would feel the skin exces- 
sively dry, and parched with heat: a pulse hobbling or 
intermitting, slow or frequent, full or small, but always 
tease. He would behold the patient tortured with ex- 
cruciating pains, rendered less supportable by constant 
exertion to vomit, till delirium mingled with his groans a 
frantick laugh or song.' 

'At certain periods, the heat of the skin would abate 
for a short time, but every other symptom would con 
tinue with unremitting violence.' 

'But at length the skin would become cool; the pulse 
lose its tension and frequency, and every pain cease. 
The fiery redness of the eye would disappear, and assume 
the yellow T livery of bile. A yellowness would appear 
about the neck, and gradually extend itself over the 
whole body. A vomiting of a black fluid would occur, 
resembling the grounds of coffee. The patient would 
he sensible of immense and oppressive weakness. As 
these symptoms increased, the lips would appear cede- 
.matous, and the tongue swoln. The skin would be cold, 
and impart on pressure a sensation like that of a dead 
person. The pulse would continue preternaturally slow, 
and generally acquire fulness as death, approached. A 
hiccup would at length occur, the pulse rapidly seemed 
to pause after every pulsation, as though it were to beat 
no more. The blood bursts from different parts of the 
body; the action of the arteries is no longer felt; the 
heart gradually ceases exertions, while delirium and con- 
vulsions announce the victory of death.' 

"The primary cause of the preceding catalogue of 
symptoms, will require a distinct letter hereafter. We 
will then search into the origin of a disease, whose ra- 
vages have not been confined to one ill fated portion of 
the globe; and therefore we need only remark in this 
place, that its appearance in Baltimore 'seems not to 
have arisen from importation, but from an internal source.* 
It will appear also that the first cases originated from a 
domes tick cause,' but that its subsequent extensive range 
depended in part on communication of contagion.* 

* Here that correct reasoning which is so strongly marked ot; 
every page, seems for a moment to have forsaken onr amiable 



128 HISTORY OF THE YELLOW FEVER 

"But to rouse the original seed of disease into actual 
fever, generally requires the co-operation of secondary 
causes to which schoolmen have affixed the name of ex- 
citing or occasional causes. Among these we may par 
ticularly enumerate/ 

1. Intemperance. 

'Almost all the first victims of yellow fever, were 
persons habituated to the immoderate use of ardent spi- 
rits: and it is a melancholy truth, that very few of these 
unfortunate creatures could be rescued from death, by 
all the powers of medicine. So intimately are morals 
connected with our physical happiness; that we need but 
look around us with the eye of reason, always to engage 
in our pursuit of the one, the company of the other. 
All the first occurrences of mortality by the yellow fever, 
were generally ascribed to the primary influence of rum. 
The mind was unwilling to admit of a more hideous 
cause, while this offered to its choice. 

'In drinkers of ardent spirits, the fever was excited 
not only with more facility, but was attended also with 
irresistible violence and maliimitv.'' 

<!bven a moderate, but unusual indulgence in those 
liquors, soon roused the disease into action. A glass 
of wine would occasion a headach in those who were 
much exposed to the exhalations of the sick, or to the 
air of infected places; and for a considerable time in 

author, in supposing the same cause which originated the disease, 
was not the most likely to extend it The whole tenour of this 
history as well as the concurring testimony, of a vast number of 
the most experienced ihysicians, clearly establish that those per~ ; 
sons who breathe the vitiated air, loaded with that kind of miasma 
which produces yellow fever, may and do excite the disease in va- 
rious ways, as by intemperance. 

And nothing is more clearly established than that this miasma is 
independent of febrile action. But when we recollect, that the no« 
tions of contagion which had been handed down by the too credu- 
lous writers, pretty generally, up to our author's time, instead of 
wondering at his giving this opinion of contagion, we are compelled 
to admire his acute discernment, in tracing the fever to its real- 
source. 



OF ? 94, AT BALTIMORE. 129 

September, half the quantity would affect me in a simi- 
lar manner.' 

•The intemperate use of food also frequently gave ex- 
istence to t< e latent disease. A large supper of oysters 
excited the fever in one person. Even indulgence in ac- 
customed meals, or in particular substances, was some- 
times attended by similar misfortunes. A dinner of ani- 
mal food would often cause an acute pain in the back for 
three or four days. The fever was excited in a gentle- 
man before he had completed his supper; and in another^ 
by using a small quantity of cucumbers at his dinner/* 

2. Heat 

•This was a very frequent exciting cause, especially 
when combined with fatigue, either of walking, riding 
on horseback, or labour in the sun. To the latter cir- 
cumstance must, in a great degree, be attributed the more 
general prevalence of the fever among the labouring class 
of the citizens. The heat of a fire produced, in several 
instances, the same effect. Hence blacksmiths suffered 
peculiarly with the disease. Sitting, in the cool even- 
ings or mornings of September, over a fire, caused an 
exacerbation or return of fever in some who were in a 
convalescent state.' 

3. Cold. 

'Cold/ says Sydenham, 'has destroyed abundance 
more than the sword, plague and famine, together.' 

'The cold air and dews of night excited the fever in 
a great number of those who were diseased. These 
powers acted with peculiar force, especially when pre- 
ceded by sleep. A gentleman was attacked with the 
disease immediately after falling accidentally into the 
river. The transition of the atmosphere from heat to 
cold, which occurred about the twentieth of September, 

.. *Some of those trivial exciting causes mentioned, may be acci- 
dently simultaneous with the attack: a lurking disease may break 
out from exciting causes, which are not remembered, and induce us 
sometime? to attribute the attack to that which is present 

17 



180 HISTORY OF THE YELLOW FEVER 

and continued three or four days, added considerably to 
the number of the sick; nor did the cold weather, which 
occurred after the beginning of October, check the pro- 
gress of the disease until aided by heavy frosts.' 

4. Sleep. 

"Many persons awoke, in various hours of the night* 
with a chill or fever. Some were not attacked till the 
dawn of day. 

5. Marsh Miasma. 

"I am disposed to rank this among the exciting causes, 
when the body had been previously exposed to conta- 
gion; nor is it one of the most inconsiderable.* This 
acted, when those already enumerated appeared to have 
been insufficient to produce disease; for a person, in 
whom the seeds of the fever were received, very fre- 
quently escaped its powers by exposition to pure air. 
Hence the disease prevailed most virulently about its 
primary source; and seemed more innocuous when car- 
ried to another place free from the influence of marsh 
miasma. On Bowley's wharf the prevalence of a north- 
erly wind during one day, would be succeeded by the 
sickness of several persons. 

'The wind blew the water out of the docks so much, 
as to expose the mud to the action of the sun. The noi- 
some exhalations combined their powers with those of 
the contagion already acting on the body, and excited 



* Here our author is misled again in his notions of contagion. 
Such is the force of habit, in reasoning, as well as in bodily actions^ 
that the lessons which he had gotten were so strong as to deceive his 
own better judgment. Nothing can be a stronger argument against 
contagion than the variance of the facts here detailed, with the ex- 
tension of the fever: it was confined to the lower part of the city! 
It is somewhat strange, then, that Dr. Drysdale, whose discernment 
enabled him to discover the existence of yellow fever before conta- 
gion could exist, should afterwards place miasma among the exci- 
ting causes, when it was evidently the remote and predisposing 
cause. But the mind, when chained down by fashion, is often con- 
fined to limits, which detract from the judgment. 



OF '9% AT BALTIMORE. 131 

fever. On the Point the gentle showers of rain which 
frequently fell, were succeeded by an increase of pa- 
tients; those sources of miasma, which had been dried up 
by the sun, being again supplied with sufficient moisture 
and heat to generate putrid exhalation. 

" Accidental circumstances sometimes excited the dis- 
ease. A mate of a vessel, having received a blow on 
the head from a cable, was immediately attacked with 
the fever. 

"Among the exciting causes, some of very discordant 
properties are enumerated. To account for their effects 
in producing the same disease, we must recur to the pe- 
culiar nature of the fever itself. 

'The debility attending it, like that of pleurisy, is of 
the indirect kind, or produced by excessive action of sti- 
muli upon the body.' That it was of this nature, may 
be inferred from the symptoms of the disease, and from 
that mode of treatment which proved most successful in 
its cure. "Causes which produce direct debility, are not 
preceded by a tense pulse, nor can their effects be coun- 
teracted by debilitating medicines. It may be inferred 
also from the means which prevent the contagion, when 
the body is impregnated with it, from arising into actual 
fever. Did it tend to direct debility, would not those 
powers which abstracted stimulus from the body and 
gradually weakened all its functions, accelerate the for- 
mation of disease? And would not those persons, already 
labouring under direct debility, be most subject to its in- 
fluence? But the causes of the yellow fever, like that of 
the smallpox, and wine, produces debility of the indirect 
kind. In the latter disease, physicians endeavour to 
counteract this effect by debilitating remedies. 

"A moderate quantity of wine gives increased action 
to the heart and arteries; but when drunken in excess, 
it is followed by indirect debility. When the body is 
impregnated with the contagion of yellow fever, disease 
must not necessarily ensue. Its own stimulus is not 
always sufficiently powerful, by itself, to produce this 
effect; but when assisted by ardent spirits, animal food, 
keat, or violent exercise, fever is excited. Is it not suf- 



13& HISTORY OF THE YELLOW FEVER 

ficientty obvious that, under the influence of these causes, 
excess of arterial action must ensue? 

-"Br. Condiet, in his inuagural thesis on contagion,, 
published last spring, has, in my opinion, sir, treated 
this subject so ingeniously, that it will be unnecessary 'J 
to dwell here any longer on this part of our subject. 

"But among the occasional causes are cold and sleep, 
and to these we may add grief and fear, which cannot be 
said to stimulate the body. I admit this truth under cer- 
tain restrictions. So far from these powers giving in- 
crease of stimulus to the body, they tend to induce direct 
debility, because they are of a negative nature. But let 
this principle in philosophy be remembered, that the ab- 
straction of stimuli from the body is followed by in- 
crease of its excitability; this being necessarily augmen- 
ted when the means of exhausting it are diminished in 
number.* Evacuations which have been injudiciously 
immoderate, have occasioned the occurrence of fever on 
the same principles which explain its formation after 
cold or sleep. 

"Those who were exposed to the contagion, would be 
affected with headach, a heat and sense of fulness or 
oppression in the stomach, want of appetite, a disagree- 
able taste, and costiveness, a burning of the hands and 
feet at night; restlessness or drowsiness; heat of the 
skin, alternately with profuse sweats, frequently of a 
yellow colour. These symptoms were not always suc- 
ceeded by disease, yet they proved the precursors of the 
fever. 

"Those premonitory symptoms did not precede every 
case of fever. It would often seize upon its victims 
with sudden violence, while occupied in the various em- 

* This was the philosophy of our authors day, and continues, per- 
haps, to prevail very generally; but I am disposed to call its accura- 
cy in question. Excitability, whatever it be, is subject to expendi- 
ture, and it is expended by exertions, or stimuli operating on it. 
Now, although it seems to be a law of the animal economy, that 
more effect shall arise from the application of a stimulant, in a de- 
bilitated body, yet that increase of effect is not owing to an augmen- 
tation of excitability, but to a morbid susceptibility of this principle, 
from which it is liable to be thrown into inordinate action. 



OF '94, AT BALTIMORE. 133 

ployments of life, or engaged in the pursuits of business 
or pleasure. A shaking or chill would usher in the dis- 
ease in some, and from its degree of intensity we might 
suspect the violence of the ensuing case. 

"The influence of the late yellow fever was discover- 
ed under the following appearances as it related to the 

PULSE. 

"The pulse was tense in every form of the disease, 
from its first appearance till its declension in October. 
It bore this peculiar character in the remissions of the 
fever; and even when it commenced its career, under the 
insidious cover of an intermittent. It was also quick; 
the mind would be deceived into a belief, that the pulse 
was slower than it really was, upon account of this pe- 
culiarity of its nature, the systole of the heart being per- 
formed in an instantaneous period of time. 

"Under the impression of every temperature of the 
air, and under every degree of violence of the disease, 
the pulse held forth another emblem of its character, by 
hobbling through its functions. A full pulsation was 
succeeded by another of less force, and no two strokes 
resembled each other in frequency. In one person, 1 
counted three pulsations in one sixth of a minute; in 
another sixth, they amounted to the number of fifteen. 
This irregularity was more or less observable in every 
case, and in every period of the disease. 

'The tension of the pulse is so common an occurrence 
that it will be useless to dwell on it for a moment. When 
the fever was uncontrolled by medical aid, or treated im- 
properly, the blood vessels were ruptured by the violent 
morbid action. In these cases also, which were not op- 
posed with sufficient force, even when the patients were 
rescued from the grave, hoemorrhages would occur in a 
small degree, before the final crisis of the disease. The 
blood bursted more generally from the nose, but it pour- 
ed also forth from the ears, mouth, bowels, and urinary 
bladder. 

"Respiration was much impeded. It was hurried and 
laborious. As the coldness of the season increased, the 



134 HISTORY OF THE YELLOW FEVER 

determination of the blood to the lungs, became more 
obvious. Pains in the breast became more common, and 
a cough, with sometimes expectoration of phlegm, more 
frequently accompanied the disease. The nerves were 
not so much diseased, as to occasion frequently tremours 
or twitchings of the tendons. They in some cases ac- 
quired such a morbid degree of sensibility as to render 
the whole body sore to the touch. The total destruc- 
tion of the appetite for food was very remarkable in the 
yellow fever: nor did it return in the least degree during 
its remissions. It marked so well the violence and dan- 
ger of the fever, that a return of appetite for food pro- 
ved the most certain sign of a favourable issue; nor 
could the patient be ever declared out of danger, while 
the total disrelish for food continued, notwithstanding 
the presence of other symptoms apparently favourable. 
The thirst was excessive in some instances; but in gene- 
ral it was moderate and sometimes absent. When pre- 
sent, water was much desired, and acid drink, such as 
lemonade were grateful. 

"1 will now proceed, sir, to mention that mode of cure 
to which the yellow fever submitted. I have long ob- 
served the superior efficacy of mercurial purges over 
those of any other kind, in bilious diseases. Blane, 
found 'five or ten grains of calomel succeed in evacua- 
ting bile, when other purges had failed in this effect.' 
Mercury not only cleanses the bowels, but acts also 
powerfully over the whole glandular system, and causes 
a diaphoresis, when other medicines have proved inef- 
fectual in opening the skin. It seemed, therefore, ex- 
cellently adapted in combatting the yellow fever: 'and a 
soreness of the gums, or a gentle salivation, gave me 
pleasure on their appearance, as the first tokens of the 
impregnated state of the body. 

k The good effects of such a circumstance have been 
noticed by Wade and Chisholm: the former gentleman 
lost no patient; and the latter, but one out of a very 
great number, in whom the mercury caused a salivation. 
You, also, sir, have added another testimony to theirs, 
by informing us that you lost but one person, in whom 
a ptyalism occurred; and out of many who came under 



OF 9 9% AT BALTIMORE. 435 

my observation, I know not an exception to their reco- 
very from disease. 

<To give small doses of calomel in yellow fever, is to 
diminish the probability of a cure by losing time. Their 
effects, if they produce any, will be of very little conse- 
quence. If evacuations be too sparingly made, says 
Pringle, a bilious remittent will become continued. 

'As a purge/ says Dr. George Davison, of St. Vin- 
cent's, 'calomel has been used with the greatest advan- 
tage; sometimes by itself, but more frequently combined 
with some active purgative medicine, such as jalap, 
From some peculiarity, an uncommon quantity of calo- 
mel is necessary to affect the bowels and salivary glands. 
As I found small quantities of it did not produce the 
effect wished for promptly, I gradually increased the 
quantity, until I now ventured to give ten grains of it, 
combined with five of jalap, every two hours, until stools 
are procured. The calomel is then given by itself.' 

'There are many other testimonies in favour of large 
doses of purging medicines, to remove childish fears in 
their exhibition. The great Sydenham used to admi- 
nister twenty grains of sweet mercury in a dose, either 
alone or combined with other purgatives. Chisholm 
gave an hundred and fifty grains of calomel in one case, 
with evident advantage. You have adduced irrefragi- 
ble proofs of the utility of a similar practice.' 

"At the first appearance of the fever, I combined jalap 
with calomel; gave each in a small dose of eight or ten 
grains: they were repeated every five or six hours, until 
the bowels were freely opened. From four or Hive, such 
doses, exhibited during the two or three first days; I did 
not observe an instance of salivation; and although fre- 
quent evacuations from the bowels occurred, yet they 
were small, and brought with them but very trifling re- 
lief. The patients were harassed by repeated calls to 
the closestool, and the necessary exertions on these oc- 
casions, weakened them more than the discharges with 
which they were attended. This circumstance, together 
with the reflections that I always failed in my endea- 
vours to excite a salivation after the third dav, in violent 
cases, by means of the ointment and small quantities of 



136 HISTORY OF THE YELLOW FEVER 

mercury, determined me to increase the quantity of each 
dose, from the first hours of the disease. 'Fifteen grains 
of calomel, still combined with the jalap, flattered my 
hopes, by the increased advantages obviously following 
their administration. The evacuations from the bowels 
were less frequent and harassing to the sick, than when 
smaller doses had been given, but being much more co- 
pious, they were accompanied with speedier and more 
sensible relief. Yet a salivation scarcely ever occurred , 
The jalap seemed to carry the calomel too quickly 
through the bowels. I, therefore, omitted it entirely, and 
gave the mercury alone, in doses of twenty grains, every 
four or six hours, until two or three copious discharges 
were produced- If one dose of this medicine acted, it 
seldom operated more than twice. The addition of 
twenty more grains scarcely increased the evacuations 
beyond their natural quantity. In another case, thirty- 
six grains of calomel operated but twice; thirty more 
grains required the assistance of castor oil to produce 
another discharge. In another case, forty grains in two 
doses, one taken at nine o'clock in the morning, and the 
other at three in the afternoon, produced but three stools; 
another scruple was now given, which operated once or 
twice more. These uncombined closes of calomel soon 
excited a gentle salivation. As soon as this occurred, 
I had recourse to other purgatives to open the bowels 
two or three times daily: castor oil, small doses of salts, 
glauber salts and cremor tartar, but more especially 
emollient glisters, produced the desired effect. When 
large doses of calomel were given, the evacuations from 
the bowels were very copious and few. The exertions 
of the patient were more than compensated by the dis- 
charges which required them; the oppression was remo- 
ved, and lie felt revived. 'I never saw a case in which 
fifty or sixty grains of mercury had been given in three 
doses, accompanied with one half of that sense of im- 
mense weakness which attended the exhibition of fifteen 
or twenty grains divided into three or four parts. The 
weakest constitutions were not injured by large doses of 
calomel. Delicate girls and women derived advantages 
from it, equally with robust men/ The life of an infant- 



OF J Q% AT BALTIMORE. 13? 

scarcely five months old, was preserved by taking fre- 
quently five or six grains of calomel in a dose. The 
effects of calomel purges were great and obvious. Their 
operation was assisted, and perhaps sometimes varied, 
by the bleedings used at the same time. 

1. "In some instances, the mercurial purges in two or 
three hours, produced sensations of needless dartings 
through the whole body. These lasted but a moment, 
and were succeeded by an universal sweat. 

2. "The first dose often excited vomiting two or three 
times, but being attended wich very little nausea or retch- 
ing, it proved a more safe and less irritating emetick than 
the preparations of antimomy, and vomited only when 
there appeared to have been an accumulation of bile. 

3. "The large doses produced but few discharges from 
the bowels: they were very copious, however, and attend- 
ed with great relief to the sick. 

4. "By removing excess of stimulus and immense op- 
pression, they revived the patient, and gave him an in- 
crease of strength. 

5. "When the pulse was very low, the copious evacu- 
ations from the bowels were followed by increased ful- 
ness and diminished frequency of the pulse. And when 
it was preter naturally slow, they raised it to a more na- 
tural degree of frequency. 

6. "They moderated the violence of the fever, removed 
the pains especially from the back, and obviated the re- 
turn of severe exacerbations. Hence they alone were 
frequently sufficient to arrest the progress of the disease. 

7. "They caused the vomiting to cease when it ac- 
companied the commencement of the fever: and very 
often small doses of calomel, repeated every one or two 
hours, prevented the return of the vomiting of coffee 
grounds, even after they had made their appearance. 

8. "By means of large doses the whole system was 
soon impregnated with mercury, and the various glands 
resumed their suspended functions. The general diffu- 
sion of this medicine through the body, was announced 
by a tenderness of the gums. <I saw no case terminate 
fatally after a salivation, however violent they had pre- 
viously been. The sooner the bowels were well opened, 

18 



138 HISTORY OF THE YELLOW FEVEE 

the greater was the prospect of x*ecovery; ; and when ft 
salivation was excited, it was necessary to procure at 
least three stools daily, by castor oil or glysters. This 
prevention was very necessary for the lapse of a few 
hours, without an evacuation was frequently followed by 
increased anxiety, an increase or return of the fever. 

"I shall now consider the effects of blood-letting in 
yellow fever. 

1. "When the pulse was very frequent, venesection 
rendered it more slow; when very slow it gave it fre- 
quency, and when depressed and small, it gave it ful- 
ness. This latter circumstance is often remarked by sir 
John Pringle in remittent fever, and by Donald Monro, 
in dysentery. 

2. "Venesection removed the delirium and the coma- 
tose state, with which the sick were tortured or oppress- 
ed: it likewise removed wakefulness; and very frequent- 
ly acted like an anodyne, being succeeded by two or 
three hours' refreshing sleep. 

3. 'It promoted the operation of the calomel in opening 
the bowels.' Hence I have frequently heard the patient 
call for the closestool, while the blood was flowing from 
his arm, although the bowels had previously appeared 
obstinately costive. 

4. "It checked the violent vomiting in the first stage 
of the disease, which had resisted every other remedy: 
and when a hiccup accompanied its first attack, it yield- 
ed to the same remedy. 

5. "It was frequently succeeded by a general perspi 
ration, and sometimes by a profuse sweat. 

6. 'It removed the sense of oppressive weakness, and 
inspired the patient with new strength and vigour/ 

"The pains did not always vanish after bleeding; they 
were frequently increased by one or two detractions of 
blood. Where pain had only been felt in the head, one 
bleeding has caused it to rage also in the back and limbs. 
This occurrence was not new to me: I had formerly bled 
an old negro man, who complained of some fever, and 
considerable pain in his breast: he lost one pound of 
blood, but in the succeeding hour, the pain had so much 
increased, and had become so intolerably acute, that I 



9E '94, AT BALTIMORE. 139 

was obliged to permit the blood to flow, until it produced 
an abatement of his state: this was affected by the addi- 
tional loss of twenty ounces, by which his cure was com- 
pleted. Whenever this circumstance may occur in the 
yellow fever, the increase of paiu ought not to deter U6 
from a repetition of blood-letting: a second or a third 
bleeding may be necessary to subdue the violent motions 
to which the vessels had been restored by the first/ 

"When the system was reduced by purging aud bleed- 
ing, so far as prudence would direct the repetition of 
these remedies, and when the action of the vessels was 
still affected with some degree of febrile irregularity, 
blisters were applied with advantage to various parts of 
the body, particularly the head and wrists. In many 
slight cases they were made use of in the first stage of 
the disease. But I am inclined to believe, that the pa- 
tients would have recovered sooner without them." 

'When towards the close of the disease, a burning 
pain was seated in the stomach, a liniment of laudanum 
and sweet oil sometimes proved serviceable: but when it 
was more obstinate, equal parts of molasses, milk, and 
castor oil, taken frequently in small doses, effected its 
removal.' The troublesome vomiting which occurred on 
the third, fourth, or fifth day of the fever, was frequently 
appeased by the same remedy. A large draught of new 
milk, sometimes equal to a pint, assisted very much 
in checking the black vomiting in some instances, in 
which it was tried. But the remedy on which the most 
reliance could be reposed, was emollient glysters, occa- 
sionally administered. 'Glysters were always produc- 
tive of good effects, after the necessary exhibition of mer- 
curial purges. They prevented the occurrence of vomit- 
ing and checked it when existing. I have sometimes 
checked the last harassing vomiting, by small doses of 
calomel, very frequently repeated. After the reduction 
of the system by the evacuating plan, an interval suc- 
ceeded, in which medicine was no longer required. To 
use stimulating or tonick medicines was dangerous. The 
cure, therefore, was submitted to something a little nutria 
tious, as weak broth, in small quantities; and the symp- 
toms soon indicated whether stimulating soups^ oysters, 



140 HISTORY OF THE YELLOW FEVER, &C. 

chocolate, mush and milk, &c. might be admitted.' In 
this stage the case was almost totally relinquished to such 
means, and to the attention of the nurse." 

"Cool air was as necessary to the sick in the disease, 
as bleeding." <I always ordered the room of the patient 
to be kept well ventilated, by opening the windows, re- 
moving the bed-curtains, and placing the bed when 
practicable, in the middle of the room. The good ef- 
fects of air, were well demonstrated by the influence a 
confined room exerted over the sick.' 

The application of cold water alone, or mixed with 
vinegar, to the head, on napkins, moderated its burning 
heat, and afforded the most grateful relief to the patient. 
It greatly mitigated the confusion of the head. Wash- 
ing the' face, hands and feet with cold water, always 
proved equally serviceable. While it refreshed the pa- 
tient, it sometimes totally removed the remains of a se- 
vere headach. I experienced this circumstance also in 
my own case, when a large dose of calomel had proved 
insufficient to remove the pain. "The drinks also used 
by the sick were either cool or cold. Mild herb teas, 
lemonade and jelly, tamarind, apple, or very weak 
chicken water,* toast or milk and water, in every stage 
of the disease were used indifferently, according to the 
wishes of the patient. Water alone was frequently de- 
sired, but could seldom be granted. A table spoonful 
was sometimes given, but this drink was very apt to ex- 
cite vomiting, especially in the advanced state of the 
fever. 

In some cases drinks acidulated with some of the ve- 
getable acids, proved most agreeable. The elixir vi- 
triol was always nauseous, and frequently occasioned 
vomiting. Weak 'coffee and tea? were pleasant, and 
used with safety in any stage of the disease. 'Wine' 
was universally nauseous, even in the smallest quantities, 

* I am constrained here, to caution the reader against any thing 
like a libera! use of chicken water. In fevers of high inflammatory 
action, it cannot possibly be a suitable think; but so soon as there 
is good evidence of abatement of the disease, it will be a grateful cor- 
dial, and give a little sustenance, at a time when it is first necessa- 
ry, or perhaps even safe. 



CONCLUDING ADVICE ON YELLOW FEYER. 141 

and in every form in which it could be taken, its effects 
it eembled, on a smaller scale, those of laudanum. 
When swallowed in the fever,- if it did not occasion vo- 
miting, it caused a burning heat in the stomach, or de- 
lirium. 

'A view of the yellow fever as the synochus of Dr. 
Cullen led to a pernicious mode of treatment. The pa- 
tient was first bled, then bark, laudanum, &c. were ad- 
ministered, in order to provide against an expected state 
of debility/ 

'The mind was prepossessed with a notion of ap- 
proaching putridity, and the appearance of inflamma- 
tory action in the commencement of the fever, was totally 
disregarded, or looked upon as a foe in ambush! How 
much to be regretted, that the name of a disease should 
ever have more potent influence over the judgment, than 
the symptoms with which it is accompanied!' 

"During the prevalence of the late yellow fever, it is 
to be remarked, that the smallpox did not vanish, but 
retained its ground. But this is not an objection to the 
opinions hitherto advanced. Is not the yellow fever a 
disease highly inflammatory? So is the smallpox. Was 
this remitting fever more inflammatory than usual, and 
from the particular constitution of the season? So was 
the smallpox." 

I here close this abstract, and regret that this account 
could not have been presented entire. Its length, howe- 
ver, would not well admit insertion in a volume of this 
size. I shall now close the subject of yellow fever, by 
a few practical remarks. 

SUBSECTION III. 

Concluding advice on Yellow Fever. 

Has the yellow fever become prevalent in a neigh- 
bourhood, it becomes indispensably necessary for all 
those who cannot leave the place, to become particularly 
temperate in every respect. By due attention to mode- 
ration in eating, drinking, exercise, sleep, &c. many 
will escape the disease. Should an attack come on, it 



142 CONCLUDING ADVICE ON YELLOW PEVEfc. 

is no longer safe to attempt removal; death is the certant 
consequence of such a measure. It will now be the 
safest course to remain quiet, and attack the disease with 
spirit. If medical advice, in which you confide, can be 
had, it is the duty of every citizen to procure advice 
If that cannot be had speedily, it will always be advi- 
sable to take fifteen or twenty grains of calomel, with 
half that quantity of jalap, every three hours, till your 
bowels are freely opened. If this should not afford 
manifest relief as soon as it has operated freely: a bleed- 
ing will be necessary, and should be regulated accord- 
ing to the constitution, and violence of the disease. 
From twelve to twenty ounces may be taken. 

Should the symptoms even now abate, get advice if 
practicable, for this fever is sometimes extremely insi- 
dious; and putting on an appearance of retreat, too often 
leads its victims into false security. If advice is still 
not to be had, take calomel in doses of from three to six 
grains, according to age, &c. every two or three hours, 
until you procure a slight soreness of the gums. Should 
the symptoms run high, the bleeding must be repeated 
till all violent pains or fever are subdued; and, at the 
same time, keep the bowels freely open by the use of 
injections. 

Should the attack be moderate, still it will be impro- 
per to delay: use the calomel as above advised; and if 
you shoukl, notwithstanding, become worse, bleed; and 
repeat the calomel and opening injections. In violent 
attacks which seem to oppress the stomach particularly, 
or where it has been preceded by nausea for some days, 
it will be advisable to combine about twenty grains, 
more or less, according to circumstances, of ipecacuanha 
with the first dose of calomel. This will generally ope- 
rate freely, without much straining, and instead of weak- 
ening, will generally impart strength to the patient. 

A free admission of air is as essential as medicine; 
and, therefore, a large, well- aired room, with a hard* 

* The patient's habits may, however, be consulted respecting their 
bfd; for corpulent or very delicate persons, the bed should not be 
too \va.\il. 



Concluding advice on yellow fever. 148 

bed without curtains, should be preferred. Animal food 
of every kind, even chickenwater, is improper; at least, 
in seasons when the symptoms run high; or, perhaps, 
more correctly speaking, in seasons in which a very in- 
flammatory constitution of the air prevails. It has been 
remarked, both in the foregoing account of yellow fever, 
and also by Dr. Rush, in '93, that tea and coffee were 
always grateful drinks. They ought not to be taken 
too warm. Lemonade, toast and water, milk and water, 
and very weak pleasant herb teas, as balm, ground ivy, 
and hysop, &c. are pleasant and proper drinks. I have 
great partiality for toast and water as a drink, in all ca- 
ses where the stomach is disordered. 

Wine, or ardent spirits, are even poisonous in every 
case, in the early stage; and are seldom admissible till 
the convalescence is well advanced. I think it may 
safely be laid down as a general rule, in this disease, 
that stimulants ought never to be used without the ad- 
vice of a skilful physician. 

Have you been under the necessity of combating the 
disease yourself, and well assured your disease is check- 
ed; leave the rest to nature, remain quiet; take mild, 
nourishing diet, in very small quantities, and if the ap- 
petite calls for it, repeat it often; taking great care to 
begin with the milder articles first, as chocolate, mush 
and milk, well-boiled rice, or barley, reasonably sea- 
soned; then light broths, &c; and lastly, with the ut- 
most caution, resume the use of meat 

Should you have checked, in good measure, the more 
severe symptoms, and a lingering feverishness, want of 
appetite, with occasional nausea and imperfect sleep, &c. 
continue, it will be advisable to apply blisters to the 
wrists, or ankles, or even the stomach, if that viscus is 
affected; but it ought to be well ascertained that the force 
of the fever is broken, before they are applied: these, 
with the free use of glysters, will generally remove 
those lingering symptoms. 

To sum up all in the fewest possible words, those un- 
skilled in medicine ought to trust, where advice is not to 
be had, to the liberal use of calomel; the lancet, free ex- 
posure to cool air, and the constant use of injections: 



140 HISTORY OI IHh YELLOW FEVEK, cV 

chocolate, mush and milk, &c. might be admitted.' In 
this stage the ( mm- w as almost totally relinquished to such 
means, and to the attention of the nurse. " 

"Cool air WM as necessary to the sick in the disease, 
as bleeding." <I always ordered the room of the patient 
to be kept well ventilated, hy opening the windows, re- 
moving the bed-curtains, and placing the bed when 
practicable, in the middle of the room, The good ef- 
fects of air, were well demonstrated by the influence a 
confined room exerted over the sick.' 

The application of cold water alone, or mixed with 
vinegar, to the head, on napkins, moderated its burning 
heat, and afforded the most grateful relief to the patient. 
It greatly mitigated the confusion of the head. Wash- 
ing the' face, hands and feet with cold water, always 
proved equally serviceable. While it refreshed the pa- 
tient, it sometimes totally removed the remains of a se- 
vere headach. I experienced this circumstance also in 
my own case, when a large dose of calomel had proved 
insufficient to remove the pain. "The drinks also used 
by the sick were either cool or cold. Mild herb teas, 
lemonade and jelly, tamarind, apple, or very weak 
chicken water,* toast or milk and water, in every stage 
of the disease were used indifferently, according to the 
wishes of the patient. Water alone was frequently de- 
sired, but could seldom be granted. A table spoonful 
was sometimes given, but this drink was very apt to ex- 
cite vomiting, especially in the advanced state of the 
fever. 

In some cases drinks acidulated with some of the ve- 
getable acids, proved most agreeable. The elixir vi- 
triol was always nauseous, and frequently occasioned 
vomiting. Weak 'coffee and tea/ were pleasant, and 
used with safety in any stage of the disease. 'Wine' 
was universally nauseous, even in the smallest quantities, 

* I am constrained here, to caution the reader against any thing 
like a libera! use of chicken water. In fevers of high inflammatory 
action, it cannot possibly be a suitable drink; but so soon as there 
>od evidence of abatement of the disease, it will be a grateful cor- 
dial, w.\ give a little sustenance, at a time when it is first necessa- 
ry, or perhaps even safe. 



CONCLUDING ADVICE ON YELLOW FEYER. 141 

and in every form in which it could be taken, its effects 
tabled, on a smaller scale, those of laudanum. 
When swallowed in the fever, if it did not occasion vo- 
miting, it caused a burning heat in the stomach, or de- 
lirium. 

<A view of the yellow fever as the synochus of Dr. 
Cullen led to a pernicious mode of treatment. The pa- 
tient was first bled, then bark, laudanum, &c. were ad- 
ministered, in order to provide against an expected state 
of debility.' 

'The mind was prepossessed with a notion of ap- 
proaching putridity, and the appearance of inflamma- 
tory action in the commencement of the fever, was totally 
disregarded, or looked upon as a foe in ambush! How 
much to be regretted, that the name of a disease should 
ever have more potent influence over the judgment, than 
the symptoms with which it is accompanied!' 

"Daring the prevalence of the late yellow fever, it is 
to be remarked, that the smallpox did not vanish, but 
retained its ground. But this is not an objection to the 
opinions hitherto advanced. Is not the yellow fever a 
disease highly inflammatory? So is the smallpox. Was 
this remitting fever more inflammatory than usual, and 
from the particular constitution of the season? So was 
the smallpox." 

I here close this abstract, and regret that this account 
could not have been presented entire. Its length, howe- 
ver, would not well admit insertion in a volume of this 
size. I shall now close the subject of yellow fever, by 
a few practical remarks. 

subsection in. 

Concluding advice on Yellow Fever. 

Has the yellow fever become prevalent in a neigh- 
bourhood, it becomes indispensably necessary for all 
those who cannot leave the place, to become particularly 
temperate in every respect. By due attention to mode- 
ration in eating, drinking, exercise, sleep, &c. many 
will escape the disease. Should an attack come on, it 



146 OF THE BILIOUS REMITTING FEVER. 

I had two patients in particular, who were evidently 
rescued from the grave by this treatment. Each of those 
patients, took thirty grains of calomel every day, for 
twelve or fifteen days, and yet, but a soreness of the 
gums was excited, without a salivation. They were 
both three weeks entirely unconscious of things around 
them, and were sustained by wine and brandy, whick 
was given to the amount of a pint of each^ every twenty- 
four hours. 

Every method had been tried to prevent the bilious 
remittent from terminating in this dangerous typhus; but 
ineffectually. If large evacuations were made, with a 
view of procuring an intermission, which would bear the 
hark, the typhus seemed only to be hastened by it. 
Neither would the bark given early, after cleansing the 
stomach and bowels do better, but, by augmenting the 
disease, lessened in a very high degree the chance of 
recovery from the typhus, which was sure to follow. 

The symptoms of a common remittent are generally, 
headach, backacii, nausea, slight chills, especially run- 
ning along the back; warm skin, which very often to the 
patient feels cold, a sense of oppression about the sto- 
mach. Sometimes the chills are scarcely perceptible, 
and the patient finds himself at once in a burning fever, 
with full frequent pulse, at other times a strange mix- 
ture of warm and cold sensations are felt on the skin. 
After several hours are passed in this manner, during 
which adults can seldom sleep, the symptoms gra- 
dually abate, until the situation of the sufferer is tolera- 
ble. After enjoying this respite, without however, get- 
ting wholly free from those symptoms, his distress re- 
turns, and very often with increased violence, at periods 
of about a half a day, or sometimes a whole day or more. 

Treatment. — This fever if taken early, will generally 
yield to two or three bleedings, and very often one or 
two will be sufficient, together with opening the bowels 
freely, by meruis of purges, in all of which calomel should 
be freely used. After those remedies, cooling powders 
of nitre and tartar emetick or ipecacuanha, will be useful 
taken in snakeroot tea; cremor tartar may also be used. 
But I have long since remarked that very little depen 



OF THE INFLUENZA. 147 

dance can be put on any cooling article of medicine, that 
does not actually purge. Glysters are always useful. If 
the case is protracted, and sufficient evacuations have 
been made, blisters will have a good effect. We must 
touch stimulants or tonicks with great caution, and inr 
deed they are very seldom necessary. 

In seasons when agues prevail most, and our remit- 
tents approach in some measure to their nature, which is 
sometimes the case; the bark will certainly shorten re- 
mittents, when cautiously administered in the time of the 
most complete remission. Bnt this is a practice extreme^ 
ly unsafe without the advice of a physician. Caphora- 
ted powders are often useful, at the close of remittents, 
after sufficient depletion. 

Regimen. — Abstain entirely from meat, or broth, wine, 
spirits, &c. Drink plentifully of weak teas, toast and 
water, apple water, milk and water, &c. Nothing solid 
should be eaten till the disease is well subdued, and 
even then, it must be resumed with great caution. Roast- 
ed apples, toasted bread soaked in water, or weak mul- 
led cider with bread, will afford a sufficient diet, till the 
patient is convalescent, when broth, chicken, puddings, 
&c. may be taken, but great care is necessary to avoid 
overloading the stomach. If the appetite is good the pa- 
tient should eat frequently, but never much at a time. 

Cool air and cleanliness is an essential part of the 
cure, therefore take a large airy room when practicable: 
open your doors and windows freely, and give prefer- 
ence to a hard cool bed. 



SECTION III. 

Of the Influenza. 

This disease travels with a speed, and to an extent, 
surpassing that of any other disease in the world. It is 
seldom mortal; but on our seabord, and near it, deaths 
are sometimes occasioned by it. Consumpted persons 
are also liable to be hurried off with it. Some of its 
most troublesome consequences are abscesses up the nose 
and in the ears. 



148 TYPHUS AND TYPHOID FEVERS, 

Symptoms.— This disease is so universally known, 
that I shall only give a few of its most prominent symp- 
toms. They are a peculiar sensation of rawness or 
soreness low down in the throat or breast; watery eyes; 
itching and heat up the nose; sneezing; considerable de- 
bility, with bad taste in the mouth; not apt to be accom- 
panied with nausea; more or less fever generally attends 
it. Influenza has the peculiarity of making persons who 
are subject to habitual disease, to feel as though they 
were attacked with their old complaint, especially at its 
onset. 

Treatment — Few cases of influenza require the use 
of medicine, temperate living, but by no means low, with 
proper attention to clothing, will generally carry the 
patient safely through the disease But, where the fe- 
brile symptoms, or affection of the breast, is considera- 
ble, bleeding may be necessary; but it ought never to be 
had recourse to without the advice of a physician; death 
has sometimes been the consequence of a rash procedure 
of this kind. For the cough and rawness, paregorick, 
in very small doses, taken in flaxseed tea, will be useful. 
Broths, and even animal food, may generally be safely 
eaten. Very gentle opening medicines, or rather injec- 
tions, ought to be used, so as to keep the bowels laxa- 
tive. Toast and water, or a little wine and water, may 
be used for drink; but, perhaps, nothing is preferable, 
in tiiis disease, to milk and water, or weak flaxseed tea 
made savoury with a little hyssop or other pleasant herbs. 

Where the disease is severe, the patient ought by no 
means to be exposed to the vicissitudes of the weather, 
should he even be able to go abroad; but free ventilation 
and cleanliness are essential to a speedy recovery. 

SECTION IV. 

Typhus and Typhoid Fevers. 

Fevers of those grades have prevailed throughout va- 
rious parts of the United States for some years past, and, 
in most places, with great mortality. It would require 
volumes to lay down the symptoms, remedies, and opin- 



TYPHUS AND TYPHOID FEVERS. 140 

ions, of the medical men throughout the country. It is 
a new disease of insidious character, and, withal, is cer- 
tainly a very ungovernable scourge; for few, or perhaps 
no physician in this country, can console himself with 
having treated it with a success satisfactory to his own 
mind. It is principally found in the winter months. 

I shall first notice a disease of this class, which made 
its appearance in Adams county, Pennsylvania, in the 
year 18 10 and ? 11. It commenced with sensations of 
heat and cold succeeding each other; severe pain in the 
head, limbs, and back; mostly a cough with uneasy res- 
piration; pulse nearly natural, but a little tense; blood 
generally like pleuritick; symptoms, generally, increased 
towards night; boils, or imposthumations, often appeared 
at the close of the disease, but did not seem to be criti- 
cal; delirium was a very common symptom, and when 
considerable, indicated danger. An affection of the lungs 
and chest was so constant, that in many cases w 7 here it 
was absent, at the beginning, by reason of the violence 
of fever and pains in different parts of the body, I" was 
able to predict, with certainty, that a cough, and peri- 
pneumonick symptoms would appear, as soon as the ac- 
tion of the blood vessels was lowered. In children, it 
very often put on the livery of incipient dropsy of the 
brain. It could seldom be checked in less than fifteen 
days, and upwards. Although its symptoms were evi- 
dently inflammatory at the onset, yet large evacuations 
were unsafe. An unusual torpor of the bowels existed 
in some cases. The best plan of treatment which I 
could devise, was to bleed, once or twice, moderately; 
open the bowels with calomel and jalap; and in many 
cases it was necessary to add a few grains of gamboge: 
and also, to assist those articles with glysters. Nitre and 
camphor, in form of powders, were useful as soon as 
moderate evacuations had been made. Equal parts of 
laudanum, and sweet spirits of nitre, was serviceable, at 
least, when given at a late hour of the night; at which 
time the fever was declining, and leaving the patient in 
a state of considerable debility. The use of calomel, in 
such quantities as to effect the gums, had evidently a 



150 TYPHUS AND TYPHOID FEVERS. 

very happy effect in some cases, and certainly rescued 
the patient from the grave. 

Tonicks, or powerful stimulants, were never necessa- 
ry; mild, nourishing diet, with a decoction of Iceland 
moss, infusions of valerian or snalceroot, were generally 
the best remedies, during the early stage of convales- 
cence, and very often after a single bleeding. As usual 
with febrile disease, this too often changed suddenly 
from a low grade of action to one strongly inflamma- 
tory, and required a repetition of bleeding, &c. to bring 
it clown. 

One very remarkable case occurred, where the dis- 
ease w r as protracted, and had twice changed its cha- 
racter, completely, from a very low to a high grade 
of disease. This patient certainly owed his recovery 
to the modern mode of treating disease according to 
present symptoms, instead of being led astray by de- 
ceptive names. After a very severe disease of about 
three weeks duration, this man became convalescent; a 
diarrhseacame on with some pain, and copious discharges 
of blood from the bowels. Tonicks and astringents 
were given, as opium with white vitriol, sugar of lead, 
&c, but to no purpose; the disease seemed unmoved by 
the use of those articles, and the patient was rapidly de- 
clining. I had road of Sydenham's fever turned in- 
wardsj of Ru sh^s misplaced fever, and on this great au- 
thority 1 resolved^ in this unpromising case, to bleed; the 
loss of about twelve ounces of blood, taken from an arm 
apparently all skin and bone, with mild laxatives, gave 
an immediate check to the disease, and the patient had 
a most rapid recovery. 

In my observations on bilious remitting fever, I have 
given some account of a typhus fever. Such is the va- 
riety of the fevers under consideration, as influenced by 
different constitutions of the weather; by change of ha- 
bits; by improper treatment, &c; that I shall conclude 
the subject by admonishing every reader to place his de- 
pendance entirely on the physician; when one is to be 
had; when not, a careful perusal of this article; that on 
bilious remittents; and especially, by referring to my 
observations on diseases of excessive excitement, and 



OF THE MEASLES. lfrl 

defective excitement or exhaustion, a tolerable know- 
of the disease can be obtained. 

Of typhus fever as arising from exposure to the foul 
air, of dirty hospitals, jails, or camps, I shall speak 
when treating of fortuitous diseases; my views being 
here confined to epidemicks, it cannot be the proper place 
to speak of a disease entirely local. 

It may be observed that, I have, in various parts of 
this work, made use of the terms dirty hospital: lest I 
might possibly be misunderstood, and my words con- 
strued into a' disrespectful opinion of hospitals, I think 
proper to observe here, that, I have in all places wished 
to convey the idea that, hospitals kept properly clean, 
and suitably arranged in other respects, are as healthy 
as any private well kept house: and therefore, lest I 
might be understood as mentioning such places as being 
unhealthy, I wish to say once for all, that it is of hos- 
pitals improperly kept I speak, when I mention the 
most usual places of malignant fever, &c* 

section v. 
Of the Measles. 

Here I have thought proper to leave the common tract, 
and class measles with epidemicks. I am not singular 
in the opinion, that measles are not contagious. Profes- 
sor Potter, of the University of Maryland, is decidedly 
of the same opinion. 

Symptoms. — This disease commences with alternate 
chills and heat, nausea, a short cough, with slight sore- 
ness of the throat; heat, itching, and obstruction of the 
nose, with severe sneezing; watery inflamed eyes; con- 
siderable lassitude; are its most remarkable, forming 
symptoms. About the fourth day, an eruption appears 
about the neck, breast and face, and spreads gradually 
over the whole body: they resemble flea-bites, being a 
little elevated, but not so much as smallpox. The ap- 
pearance of the eruption relieves the stomach and bow- 
els in some measure; but the cough and difficulty of 
breathing, most commonly increase. Bleeding at th® 



152 OF THE MEASLES. 

nose is common in this disease. About the sixth or 
seventh day; the eruption begins to turn pale, the whole 
skin having taken on a high colour; by the ninth or 
tenth, the eruption is gone, having peeled off in branny 
scales. 

If the patient has been properly treated, the disease 
now declines pretty rapidly; but if an improper regimen, 
or medicines, have been used, the symptoms become now 
more particularly dangerous; and those who die, are ge- 
nerally carried off about this time. A violent purging, 
/petechiw or purple spots, are among the dangerous symp- 
toms brought on by improper treatment, and are attend- 
ed with great danger. A sudden striking in of the 
eruption is likewise a frequent consequence of a too 
warm regimen and stimulants, and portends danger; it 
is generally an evidence of the system having been ex- 
hausted by excessive inflammatory action. This symp- 
tom may generally be prevented, but, when formed, will 
most generally yield to mild stimulants; for, in most ca- 
ses, it is now too late to deplete; but there are cases 
where the lancet is absolutely necessary, after the oc- 
currence of this symptom. This could only be judged 
of by an experienced physician. 

There are, however, cases where this sinking in of 
the eruption is owing to want of energy in the blood- 
vessels, and can only be counteracted by mild stimu- 
lants. This generally arises from constitutional debi- 
lity of the patient; to his having just passed through 
some other disease, or to a particular constitution of 
weather, which strongly predisposes to low grades of 
fever. No disease more strongly calls for the skilful 
physician; for it not only is dangerous in its course, but 
lays the foundation of many subsequent diseases, as con- 
sumption, and is apt to rouse up lurking scorfula, &c. 

Treatment — There is almost an universal errour in 
keeping patients too warm in this disease. Exposure 
to the weather, or a current of cool air, would be impro- 
per, but they should always, when able, be dressed and 
lay on their bed during the day, and be but reasonably 
covered during the night. Nine tenths, and, perhaps, 
a far greater proportion of patients will be injured, nay, 



OF THE MEASLES. 158 

life endangered, by using any tiling cordial. Weak 
flaxseed tea, wherein a little hyssop, balm, or other herbs, 
has been steeped; milk and water, barley water, and 
such like, are the best drinks; and they should all be 
used cool, but not cold. For diet, toasted bread soak- 
ed in water, weak chocolate, baked fruit, &c. will be 
sufficiently nutritious in severe cases; in more mild ones, 
a little broth, panada without wine or spirits, mush and 
milk, &c. will be suitable, and in all cases it will be ne- 
cessary to resume a full diet slowly and cautiously. 
Cordial drinks can scarcely ever be safe; in low cases, 
coffee may be allowed. Where there is much affection 
of the stomach, an emetick will be advisable. This, 
with the use of injections, and very mild purgatives, and 
the regimen pointed out, will answer every purpose that 
is to be expected from medicine. 

But the principal, and perhaps the only remedy which 
is generally necessary, is bleeding; the patient should 
be bled as soon as practicable, and it must be repeated 
till the fever and cough abate. In all severe cases, 
bleeding will be necessary about the time the disease 
has formed a crisis, and this remedy must be repeated 
even after the disease is over, while any considerable 
affection of the lungs or breast continues. 

In short, persons unacquainted with diseases, will 
know the measles best by knowing the disease prevails, 
for it always comes in the character of an epidemick, or 
endemiok. And as no disease is more easily misma- 
naged, they should get advice when practicable. If 
good medical advice is not to be had, bear in mind that 
reasonable bleeding, often repeated in severe cases, and 
a cool low regimen will seldom fail to carry the patient 
safely through the measles. All rash exposure to cold 
or heat, severe purging, strong diet and cordial drinks 
must be scrupulously avoided. 

But at the close of the disease, after due depletion, 
great advantages may sometimes be had from taking 
small doses of paregorick, or sweet spirits of nitre with 
an equal quantity of laudanum, this will mitigate the 
troublesome dry cough, which now harasses the patient, 
2Q 



154* OF THE HOOPING-COUGH. 

It may be remarked, that measles generally prevail in 
the latter winter months, and in the spring. And that, 
it is a disease to which we are subject but once. 

SECTION VI. 

Of the Hooping- Cough. 

This disease is so well known that any description of 
it would be useless. It may be remarked, however, that 
it prevails as an epidemick, more frequently than the 
measles, and fewer persons escape it in infancy. 

This cough, may often be known by the extraordi- 
nary gushing of blood into the face; even, before any 
hooping sound is observable. Such is the great length 
of continuance of this disease, that it will always be 
necessary, to keep an eye to this circumstance; and, be 
cautious how we reduce the patient. Where the symp- 
toms run high, bleeding may sometimes be necessary; 
but in general the cure may be trusted to laxative mild 
medicines, as rhubarb, or senna and manna, gentle 
emeticks of ipecacuanha. Light but pretty nourishing 
diet; as broth, puddings, milk with bread, or mush, light 
fresh meats, oysters, &c. For drink; cold water, or 
toast water, and especially, milk and water are proper 
articles. Removal, so as to get the patient into another 
air, where it is convenient, will be found useful. Ad- 
vantage is sometimes obtained from the use of tincture 
cantharides, paregorick, and other articles, but they 
should never be used without the advice of a physician. 
A pitch plaster worn between the shoulders, will some- 
times be useful, and in severe cases, I have seen the 
most marked advantages from a large blister, laid be- 
tween the shoulders. This disease will continue for 
several weeks, in spite of all remedies, and I am fully 
persuaded much mischief is done by giving too much 
medicine. 

Thousands of nauseous articles are crammed down 
the throats of the poor little sufferers, which often do 
them much more mischief than the disease. Keep your 
children from rash exposure to the weather, from over- 



OF THE SCARLATINA ANGINOSA. 155 

heating themselves, or eating too much solid harsh diet; 
and if in the winter, keep them in a room at night, of the 
same warmth, as near as possible, to that during the 
day, and this disease will seldom require any other 
treatment. 

Like in all other diseases, there will be found cases 
of hooping-cough, where evacuations cannot be used 
with safety, but where we must give a cordial diet, "the 
bark, as a tonick, and even wine whey, will be neces- 
sary. Such cases are only to be found in children of 
very weak relaxed habits, or where they are attacked 
at the close of some severe disease. 

SECTION VII. 

Of the Scarlatina JLnginosa, or Malignant Sore Throat. 

This disease partakes of every grade of morbid action, 
from the typhus to the most inflammatory disease. No 
disease more imperiously calls for the skilful practi- 
tioner than this. Its most usual symptoms are chills 
and sickness at stomach; swelling, and inflammation of 
the throat, which renders it difficult to speak or swallow, 
or even breathe with ease. The tonsils (glandular bo- 
dies, situated in the upper part of the throat, just behind 
the root of the tongue on either side) are highly inflam- 
ed, which terminates in suppuration or mortification; and 
sometimes brings away large sloughs; sometimes swel- 
lings behind the ears and blotches in the mouth. Most 
generally there is an eruption on the skin. This symp- 
tom sometimes precedes the others, and vice versa. In 
seasons where this sore throat prevails, similar, erup- 
tions are found on some persons, without any other evi- 
dence of the disease, but generally accompanied with 
some fever. 

When this disease partakes of the malignant cast, 
similar to the malignant typhus, which is most common, 
it is very mortal; and, therefore, requires skilful and 
prompt treatment. 

Where advice cannot be had in this disease, an erne- 
tick of ten or fifteen grains of calomel and half a dram 



156 OF THE SCARLATINA ANGINOSA. 

of ipecacuanha, combined, should be taken, and worked 
off with chamomile or sage tea. The calomel should 
then be continued in small doses, as three to six grains 
twice a day; and if it keeps the bowels more than rea- 
sonably laxative, laudanum should be given to restrain 
that effect. A gargle of honey and water, with a very 
little calomel combined, or an infusion of red pepper in 
water, or the steam of hot vinegar, should be constantly 
used. 

If nausea continue, repeat the emetick; then give rea- 
sonable quantities of wine, with ten to twenty drops of 
antimonial wine, every three, four, or six hours; but the 
antimonials should never be carried so far as to keep up 
nausea; it will be a safer course to depend on mild lax- 
atives, as senna and manna, or rochelle salts, or injec- 
tions, placing principal reliance on calomel. The out- 
side of the throat, and behind the ears may be rubbed 
with the ointment of corrosive sublimate; this will soon 
excite blisters. 

Cordial diet, with the use of snakeroot, or Iceland 
moss, in tea, and the use of light cordial diet, will gene- 
rally be sufficient in the close of the disease. 

Although I have said this fever is highly inflamma- 
tory, as is evident from its appearing so constantly in 
Philadelphia since the year 1783,* during the most in- 
flammatory constitutions of the weather; still, such is the 
force of the local affection, or inflammation of the throat, 
that the general system is hurried, in a few hours, through 
an inflammatciy stage, and prostrated below a state in 
which evacuations, by the lancet, would be safe; more 
especially as the disease is fixed to an unalterable course 
of inflammation, and suppuration to go through. 

The use of broths or coffee, or mush and milk, may 
be allowed through the course of the disease; but in all 
cases the quantity must be small; and it is also essential 
that very little be taken at once. Barley water, toast 
water, or chamomile tea, or porter and water sweetened, 
will be allowable drinks. The utmost cleanliness is ne- 
cessary, and free ventilation without rash exposure to 

* See Rush's Medical Inquiries and Observations. 



OF DYSENTERY, OR BLOODY FLUX. 157 

*;old air. The gargles should be used constantly du- 
ring the night; reasonable allowance being made for 
sleeping, if the patient can sleep. 

For children, who will not use gargles, a mixture of 
honey and water, with a very little calomel, may be fre- 
quently put into their mouths, and suffered to pass down; 
or the honey and water mixed with a little soda, say 
half a dram to a gill of the water, and a tea spoonful 
frequently put into the mouth. 

I have seen a solitary case of this disease in the Bal- 
timore hospital, during the late war, terminate fatally; 
yet, by great attention to cleanliness, no disease was 
communicated. It is true, this patient was removed to 
a single ward, but was attended by several persons, and 
I frequently inspected his throat, &c. The disease here 
treated on is so distinct in its character from common 
inflammation of the throat, or*quinsey, that I shall re- 
serve the latter for a section, under the head of fortui- 
tous diseases. 

secion vin. 

Of Dysentery, or Bloody Flux. 

The dysentery frequently prevails in the United States 
as an endemick, or epidemick, and sometimes prevails 
over whole neighbourhoods, or large tracts of country, 
and is found in remote places, where no possible com- 
munication with infection could have existed; so clearly 
is this disease dependant on a particular constitution of 
the air, that a physician ought to blush when he pro- 
nounces it contagious. That filthiness will increase the 
disposition to this disease, or that unwholesome diet and 
exposure to the hardships of a dirty camp, may excite a 
dysentery, I have no doubt, but this argues nothing for 
specifick contagion. Yellow fever and bilious remittents. 
by this way of reasoning, and even agues are contagious. 
But a person labouring under a dysentery, if carried 
to a healthy atmosphere, will no more communicate the 
disease, than a patient would labouring uttder yellow 
fever 



158 OF DYSENTERY, OU BLOODY ELUX. 

I have seen this disease existing as an epidemick se- 
veral times, and always unreservedly examined my pa- 
tients; often administered injections, inspected the stools, 
assisted friends to the closestool, but never had a symp- 
tom of, the disease. 

I have strong grounds for believing, I saw several fa- 
milies affected with dysentery from the imprudence of 
emptying an old necessary, and carelessly fouling the 
streets with its contents in the summer season. The dis- 
ease was not prevalent that year, but two seasons of dy- 
sentery had just preceded. We are seldom affected 
with dysentery in the middle states, according to my ob- 
servation, except at the close of summer, and the begin- 
ning of the fall months. 

This disease generally commences like fevers with 
light chills, loss of strength, and appetite. Severe gri- 
pings, and bloody, frothy, or slimy stools, without natu- 
ral feces. Sickness at stomach, and considerable thirst. 
The stools have soon an appearance of stringy substan- 
ces in them, and sometimes are almost wholly blood; the 
pain is very acute with bearing down, which is apt to 
terminate in tenesmus, or, a protrusion of the rectum or 
lower gut. Such is the persecuting nature of this distres- 
sing disease, that its unfortunate victims, have scarcely 
a moment's respite from the closestools, whilst they are 
borne down with anguish and debility. 

I am well aware of the vast importance of cleanliness 
in this disease, and believe that a want of attention to it 
will be a powerful predisposing cause to the disease, and 
often renders all efforts for its cure ineffectual. But to 
frighten people constantly with the notion of contagion, 
as some authors do, will lead to more mischief than good; 
it is the worthless part of mankind, who are moved to 
do their duty from a sense of fear only; to alarm such 
with false accounts of things is to continue them in igno- 
rance; and while ignorance clouds the human mind, man 
does his duty sluggishly, harshly, and is too often guilty 
of cruelty to his fellow creatures, and finds a pretext for 
his actions, in the notions, thoughtlessly, or unwisely IB- 
stilled by others. 



OF DYSENTERY, Oil BLOODY FLUX. 159 

Let me here admonish every christian, that it is his du- 
ty to approach his afflicted neighbour, and aid him so 
far as necessary; and here, as in all other cases he will 
find an agreement between his duty and his own wel- 
fare. Approach your sick neighbour without dread, pro- 
vided due care is observed to cleanliness, and no unne- 
cessary crowds of persons to hinder free ventilation; no- 
thing is to be dreaded from the scarecrow contagion. 
These are sentiments I carried with me during a prac- 
tice of several years, I have spent many hours with pa- 
tients labouring under every disease to which this coun- 
try is subject, and, thank God, I never had any reason to 
repent my conduct in this respect. 

Has symptoms of dysentery come on, attended with 
nausea, a dose of ipecacuanha, as twenty to thirty grains 
for an adult, should be taken; and perspiration encoura- 
ged by drinking plentifully of warm tea during its ope- 
ration. Should the febrile symptoms, as chills and heat, 
with full pulse, run high, it will be necessary to bleed, 
and even repeat it if those symptoms do not abate. In- 
jections of starch dissolved in warm water, or a decoction 
of slippery elm bark, three parts milk, and one part lime 
water, or mutton broth, should be used three or four times 
every twenty-four hours, during the violence of the dis- 
ease. As soon as the stomach is well composed after 
the emetick, which will generally be in from three to six 
hours, or where the patient has stroug objections to an 
emetick, ten or fifteen grains of calomel ought to be giv- 
en, and carried through the bowels with rochelle salt, 
castor oil, or common glauber salts, or rhubarb. Should 
the stomach reject those purgatives, and no discharge of 
natural feces follow, it will be necessary to take another 
emetick; or to lose hlood, but advice should be had if 
possible. If the foregoing treatment should not open 
the bowels so as to bring away natural stools, the calo- 
mel should be repeated and followed up by the other 
opening medicines. So soon as natural stools shall have 
been procured, the griping may be obviated by anodynes; 
take half a dram of soda, six table spoonfuls of water, 
and two small tea spoonfuls of laudanum; shake the 
whole together, and let an adult take a table spoonful 



160 OF DYSENTERY, OR BLOODY FLUX. 

as occasion may require, not oftener than twice or thrice 
a day. Rubbing over the bowels with the hand, or a 
flesh brush may have a good effect. 

In most cases of dysentery, the most simple and sue- 
cessful practice, is to open the bowels with injections; 
calomel aud other purges, as early as possible in the day, 
and at night, to take a pretty full anodyne; a pill of opi- 
um and ipecacuanha, from one to three grains of opium, 
and three to five grains of ipecacuanha, will be proper 
for an adult. 

The above treatment is best adapted to the healthy 
people of the country, but like all other diseases, this 
too is found of various grades, and in very weakly ha- 
bits, or malignant constitutions of the weather, it requires 
a course somewhat different. Here calomel and opi- 
um, with the constant use of injections, and a large blis- 
ter applied over the abdomen, are our principal depen- 
dance. The best drinks are a weak decoction of slippe- 
ry elm, mullein tea, milk and water, barley water, or lin- 
seed tea. At the close of the case, more cordial or as- 
tringent drinks will be proper, chamomile tea, dewber- 
ry tea, thin broth, and coffee, will be suitable drinks. 
In cases of a low grade, wine whey, wine and water, 
or weak punch, may be allowed, but not without cau- 
tion, for if we over- stimulate; we will increase the de- 
bility, and do our patients much mischief. For diet, 
broth may generally be allowed, and panada, ripe fruits, 
milk with well mashed potatoe, bread, or mush, mild 
soups generally; a soup made of fresh cider is a good 
article. Raw apples are always unsafe where the sto- 
mach and bowels are much debilitated; they are apt to 
produce colick. I have seen several cases, some of 
which terminated fatally in a few hours. 

Lastly. It is of the highest importance to observe the 
strictest cleanliness, in removing all filth, and ventilating 
the patient's room at all hours, sprinkling the floor (that 
is first well cleansed) with vinegar, and washing the pa- 
tient's hands and face, and rinsing the mouth frequently 
with vinegar and water, will often go far to keep down 
nausea. And in all cases it is essential that the patient 
put on flannel next the skin, and wear stockings, or at 



OF THE DYSENTERY, OR BLOODY FLUX. 161 

least socks, when they rise to the closestool; for want 
of attention to this, many persons are lost, by constantly 
having the perspiration turned inwards upon the bowels. 

Great caution is necessary in returning to a full diet, 
and to former habits generally; the bowels are left weak, 
and we are very liable to relapses: due temperance, and 
wearing warm clothes, are the requisite securities. Slight 
relapses, or a looseness, which sometimes follows, will 
generally yield to mild astringents; as a pretty strong 
decoction of the dewberry root or leaves, of logwood, 
iceland moss; or the elixir vitriol in water. 

In obstinate cases, white vitriol, or sugar lead, in the 
form of pills, with opium may be necessary; one grain 
of opium, and two or three of either of the other articles, 
may be taken once or twice a day. 

The tenesmus, and a falling down of the rectum, is 
sometimes extremely troublesome; and sometimes mor- 
tification has been the consequence. The part ought to 
be washed with warm milk and water, where this symp- 
tom has progressed; when reduced, or replaced, the 
parts ought to be well bathed with cold water, and 
often repeated. When early attention is given to this 
affection, injections of cold water and starch will be 
found a good remedy. 

Sometimes the rectum is found so highly irritable, 
that the smoothest glyster-pipe cannot possibly be intro- 
duced, here, setting the patient in a warm bath, which 
rises up over the pubis, made of poppies, mullein, or 
milk and water; or, when early attended to, a bath of 
bitter herbs will, perhaps, be most suitable. For the 
tenesmus, starch glysters will generally answer our 
wishes. 

We sometimes meet with cases where there is such 
a forcing down, that no injection can be passed. In 
such cases, this troublesome affection may be removed, 
should the bath fail, by putting a small pill of opium, a 
little within the bowel, and holding it there a few mi- 
nutes, 

St 



16& OF THE AGUE ; OK INTERMITTING FEVER. 
SECTION IX. 

Of the Ague, or Intermitting Fever. 

The ague is a disease well known, and prevails over 
a great part of the middle states, at least. It is most 
common along our waters, or in marshy, low grounds. 
A genuine ague is seldom attended with danger; but 
many of our most malignant fevers are ushered in by 
symptoms so strongly resembling ague, that people are 
often led into fatal mistakes. And hence the necessity 
of carefully reflecting, what diseases are prevalent, and 
of getting good advice, or refraining from the bark, or 
other stimulants, till the character of the disease is well 
ascertained. 

We are some where told that two of England's mo- 
narchs died of this disease; it is, however, highly pro- 
bable their deaths were occasioned by other diseases, 
wearing the livery of ague. 

It may be remarked here, that agues, or intermitting 
fevers, are distinguished by the terms of quotidian, ter- 
tian, and quartan. The first, is where there is a parox- 
ysm every day; the second, has a paroxysm every other 
day; and the last, every fourth day inclusive. These 
forms are sometimes double or blended; but in all agues 
there must be a complete interval, from every symptom 
of disease, for some time, or the disease is called a re- 
mittent. 

When it is well ascertained ague is formed, take an 
cmetick of ipecacuanha; or, what is, perhaps, preferable 
here, white vitriol, (sulplmt. zink) in doses of from ten 
grains to thirty, dissolved in water, and repeated at 
short intervals, till it causes free vomiting. Less atten- 
tion is necessary here, respecting warm drinks; they 
may impair the tone of the stomach, and are never ne- 
cessary in large quantities; chamomile, carduus, or cen- 
taury tea, should be taken in moderate quantities. The 
next day a purge may be taken; and I prefer the fol- 
lowing pills to any other: take jalap and rhubarb, each 
ten grains; aloes and calomel, each five grains; make 



OF THE AGUE, OR INTERMITTING FEVER. l6S 

eight pills, for a portion, for an adult; but the patient's 
constitution must be consulted. 

It is not material whether the vomit or purge be given 
first; and in cases where strong objections exist against 
vomiting, one or two purges, containing some calomel, 
will answer every purpose. 

If it is known that an inflammatory constitution of the 

1/ 

weather prevails, and the fever, headach, and pains in 
the bones, as it is called, run high, bleeding once, and 
in some rare cases, even several times will be neces- 
sary, before the bark is admissible. But in general, so 
soon as the stomach and bowels are cleansed, the bark 
may be taken, commencing as soon as the paroxysm is 
off, and taking it in such quantities as to take from. one to 
two ounces before the next expected chill. If the bark 
will not lay on the stomach, ii may be combined with 
about thirty cloves, and two drams of cremor tartar, to 
each ounce of bark. If this still disagree, and the con- 
stitution of the patient is good, take more calomel and 
jalap, or another emetick; or the bark may be mixed 
with cinnamon water, and magnesia, for delicate per- 
sons. 

If none of those forms will succeed: a strong ano- 
dyne, as a grain or two of opium, given as soon as the 
chill is perceived, and repeated two or three successive 
times, at the near approach of the chill, will generally 
succeed. In the intermissions, a decoction of bark, ge- 
nerous diet, good wine, or some pleasant bitter, will be 
useful. 

I have generally succeeded in curing agues with equal 
parts of Peruvian bark, and that of dogwood, or black 
oak. Arsenick and white vitriol, and opium are among 
the most valuable articles for the cure of agues, but they 
ought never to be touched without good advice; they 
may be the cause of dangerous visceral obstructions. 

Agues should be promptly treated, and relapses will 
often be prevented by temperance, and avoiding the night 
air, and by generous living. After recovery, it will be 
advisable to take a little bark occasionally. The bark 
in all cases may be taken in port wine, or snakeroottea, 
or even water or milk, as is most agreeable. It haft 



V* 



164 OF CONTAGIOUS DISEASES. 

been supposed, wearing a waistcoat with bark quilted 
between its folds, is useful iu preventing agues in chil- 
dren. 

Where agues are protracted into the cold weather, 
and sometimes attended with swelled ankles, one or two 
bleedings, with the application of a couple of blisters to 
the ankles will generally remove such remains of the dis- 
ease; these with warm clothing, generous but temperate 
living, and in severe cases the moderate use of the vit- 
riolick, or nitrick acid, well diluted with water, will an- 
swer better than the bark, or perhaps any other remedy. 
About forty to sixty drops of elixir vitriol, or the same 
quantity of the nitrick acid may be taken for a day or 
two, and then omitted for the same time, and so continue 
alternately for some time. Delicate persons, or those 
of sedentary habits will be benefitted generally, by the 
use of the cold bath, or riding on horseback, after the 
removal of agues. 



OF CONTAGIOUS DISEASES 



SECTION I. 

I HAVE, ill a previous article, given as my opinion, 
that we have but one contagious disease, at least, in this 
country, and for this we have a certain preventive in 
the vaccina, or cowpox. And it is only to he lamented 
that there is people ignorant or wicked enough to resist 
this great gift. 

Some are found who pretend they leave the issue of 
events to the Creator, but those people must either be 
extremely narrow sighted, or wilfully criminal. To 
place a dependance on Providence without the suitable 
exertions which form a part of our duty, and very re- 
lation to the various parts of creation, can only be con 
sistent with professions where it is practised as a gene 



OF THE SMALLPOX. tfjO 

ral rule. The Turk who is ignorant of the plain fact, 
that the Creator lias chosen to govern this world hy ge- 
neral laws, acts a consistent but blind part in facing 
every danger, because he believes the Great Father will 
protect him. 

But how different is the case of men, who viewing 
things by halves, will dare to say that God has sent the 
smallpox, and therefore their children may take their 
chance, and yet refuse to acknowledge the goodness of 
Him, in sending a preventive also. This is in plain 
terms, saying the Deity has sent evil, but the good is the 
work of man. I am constrained to observe here, I ne- 
ver personally kneAV a man neglect his duty in this re- 
spect, that was not a niggard at heart. This scourge is 
still found among us almost every year, I shall, therefore, 
offer a few remarks on the smallpox. 

SECTION II. 

Of the Smallpox. 

This disease attacks much in the same manner of other 
inflammatory fevers, by chills and heat, headach, back- 
ach, nausea, or vomiting, &c; about the fourth day after- 
wards, an eruption appears, and spreads over every part 
of the body; these gradually rise up into pimples, and 
they fill first with a limpid fluid, which turning to pus, 
gives the pustles the appearance of little yellow bladders: 
these appear about the tenth day, and disappear or dry 
up by the fourteenth. It has of late been distinguished 
by the terms confluent and distinct; but even for this there 
is very little necessity; the distinct being the same dis- 
ease, but of less violence than the confluent. 

Treatment, — The patient must carefully abstain from 
all animal food, even broth, butter, cheese, or eggs. Milk 
with bread, &c. weak tea or coffee, ripe fruit, toasted 
bread soaked in water, boiled rice or barley, &c. will be 
suitable diet. For drink; milk and water, toast water, 
apple water, and milk whey are proper drinks. The 
bowels ought to be opened with mild cooling physick; 
the patient to be kept quite cool, at all hours; free veti- 
lation, and lyins; on the bed during the day, and but light 



166 OF THE SLALLPOX. 

covering at night are necessary. There should never be 
more than one patient in the same bed. In persons of 
good constitutions there never can be any necessity for 
cordials. In full habits where the febrile symptoms run 
high it may be proper to take a little blood, and purge 
pretty freely. 

There are cases where the patient is too weakly to ena- 
ble the blood vessels to throw out the eruption in due 
time; even here we must by no means dispense with cool 
drinks, cool air, and a cool regimen. A little cool wiue 
whey, chicken broth, chocolate, coffee; with a few drops 
of laudanum occasionally, will be the safest treatment. 

When the disease is protracted and accompanied with 
heavy eruptions, which form crusts or scabs over the 
whole body, it will be necessary to use bark freely, with 
the reasonable use of opium or laudanum, and elixir vit- 
riol. These can never be necessary till the close of the 
usual time for the scabs drying, and even here, we must 
stimulate with caution. In short as we generally meet 
with this disease, almost every thing depends upon cool 
air, low diet, reasonable purging, cooling weak drinks, 
and in the close of the disease, a little laudanum once 
or twice a day. 

To reduce the patient in an early stage of this dis- 
sease, is dangerous, for it must run its course, and re- 
quires a reasonable energy in the blood vessels. But 
to stimulate or heat in this disease is certain death, or 
maiming, and sometimes an horrible emblem of neglect 
or ignorance is the consequence of such treatment. This 
of all others, is the most loathsome dreadful disease; 
and in every case, where it is practicable, the best ad- 
vice must be had. Having now according to my plan, 
treated of epidemick, and of contagious diseases, I 
come to speak of fortuitous diseases. 



OF FORTUITOUS DISEASES. 

SECTION I. 

Of Consumption of the Lungs. 

THE first disease which I shall treat of in the class of 
fortuitous diseases, is consumption of the lungs. 

While the yellow fever levels hundreds in a season, 
and excites the commisseration of a whole nation, con- 
sumption destroys thousands, unpitied, because its vic- 
tims are taken singly. I am, however, of opinion, that 
many cases might he prevented hy due care, and a vast 
many might be removed after they are formed. 

Much errour is practised in this disease by substitu- 
ting medicine for regimen, which alone can cure the dis- 
ease. This applies more particularly to consumption 
connected with scrofula; where it arises from common 
inflammation of the lungs, medicine alone can arrest the 
disease, in its forming stage; but when confirmed, leaves 
nothing but chronick debility to be removed by exercise 
and regimen. 

From a most careful examination of this disease, I 
have thought proper to view it first in two divisions^ 
which are in some measure opposite in their nature, and 
therefore require some difference in the treatment. 

1. Such as are connected with scrofula, which, lurk- 
ing in some part of the system, is liable to be roused up 
by inflammatory affections of the lungs. 

2. Such as arise from pneumonick affections, or other 
debilitating causes; and cases which have been impro- 
perly treated, neglected, or from violence done the lungs 
by inflammation, leaves a predisposing debility, which 
is readily acted on by cold, intemperance, &c. Each 
of those kinds of consumption have three distinct stages, 
as the inflammatory, hectick, and typhus. These dif- 



168 OF FORTUITOUS DISEASES. 

ferent stages of this disease are with difficulty distin« 
guished from each other, and hence arises one of the 
greatest difficulties in the treatment of it. 

I believe with the great Rush, that scrofula is not a 
frequent cause of consumption in the United States; 
but we are well assured that the reverse is true in Eng- 
land; and, from the rapid manner in which we are suc- 
ceeding that country in a round or succession of diseases, 
from more and more debilitating habits, we are warrant- 
ed in believing, that in our cities in particular, and even 
in the country, we are to look for scrofula as a growing 
cause of this disease. I ascribe but little to turbercles, 
in my view of scrofula; these are, perhaps, always a 
consequence, and not a cause of a consumptive habit. 
They are, probably, the eWext of chronick inflammation, 
which may be, and probably often is, wholly indepen- 
dent of scrofula; and simliar to tumours found on the 
omentum from yellow fever; on the intestines from dy- 
sentery; and, indeed, all inflamed surfaces seem dispo- 
sed to take on this appearance, or at least exudation and 
much inequality of surface. 

I believe it to be an undeniable position, that both 
kinds of consumption are bottomed on general and chro- 
nick bebility. And further, 1 believe that so far as the 
lungs are concerned in this disease, it is one and the same 
thing: and, consequently, that the difference of consump- 
tions consists of a difference in the general system. 

Scrofula is the consequence of morbid debility, inhe- 
rited or brought on by weak unwholesome diet, want of 
exercise, &c; and it is highly probable the lungs are 
less disposed to take on scrofulous action, than many 
other parts of the body. I will go even further, and de- 
clare my unequivocal opinion, that scrofula seldom, if 
ever, is principally seated in the lungs, until invited by 
chronick debility of this organ, arising from neglected 
colds, measles, intemperance, &c. Hence it follows that 
scrofula is no more disposed to induce consumption, than 
any other kind of chronick debility. And the only rea- 
son why scrofula is so generally a predisposing cause of 
consumption in England, is owing to this being the most 
common effect of chronick debility in that country. For 



OF CONSUMPTION OF THE LUNGS. 169 

a knowledge of scrofula, I must refer my readers to my 
observations on that disease. 

I wish to suggest here, that it is of the utmost impor- 
tance to distinguish between a scrofulous habit and one 
of mere debility. For the latter may exist as a mere 
diminution of bodily powers, while scrofula is ever de- 
bility of a morbid cast. Hence, when a patient is threa- 
tened with consumption, it behooves us to ascertain whe- 
ther there is lurking scrofula in the habit; for if there is ? 
the use of mercury would prove destructive. In no stage 
or form of scrofula can mercury be given without the ut- 
most danger; whereas, hundreds have been speedily re- 
lieved from consumptive symptoms, at an early stage of 
the disease, where there was no scrofulous taint, from 
the use of that medicine. 

Having now endeavoured to show the necessity of dis- 
tinguishing consumption of scrofulous habits before we 
can safely attempt the cure by mercury, and declared it 
as my settled opinion, that consumptions of this country 
will partake more and more of that character, 1 shall 
make a few observations on the disease arising from ge- 
neral debility, independent of scrofula. 

And first. It is a fact well known, that the Indians of 
our country are affected with pleurisy and pueumonick 
complaints, but exempt from consumption. 

2. It is a truth, that of the many cases of wounds in 
the lungs, from bullets and bayonets in the army, &c. 
scarcely any terminate in consumption: all these circum- 
stances go to show that consumption is not a primary 
disease of the lungs, but of the general system. And the 
circumstance that it affects females, the delicate, and those 
debilitated by intemperance, and succeeds large evacua- 
tions, as excessive purging, debilitating diseases, as mea- 
sles, protracted pneumony, &c. plainly shows the disease 
of the lungs is secondary, and is excited and maintained 
by general debility. It is true, this general debility is 
often induced by pneumony; but of all the causes from 
which consumption may arise, this is one most easily 
reached by proper remedies. Indeed, no disease will 
yield with more certainty to medicine than an incipient 
consumption from pneumony will to the use of mercury, 
succeeded by suitable exercise. It is true, the lungs seem 
S3 



170 OF CONSUMPTION OF THE LUNGS. 

to be a centre on which the principal force of chronick 
debility operates after they are brought into sympathy: 
but in all dangerous cases this is secondary. 

Hydrophobia, malignant sore throat, smallpox, and 
other violent and dangerous diseases, operate on the ge- 
neral system primarily; but still, their essential charac- 
ter consists in local affections. So with consumption, 
an essential characteristick is an affection of the lungs: 
but danger is principally to be apprehended from the 
prostration of the general system, it being primarily and 
more deeply affected. 

But, lest I confuse my readers with my attempts at 
reasoning on this disease, or possibly bewilder myself, I 
shall now endeavour to point out the disease in its differ- 
ent stages, and conclude with some practical instructions. 

In giving the. symptoms of the first or inflammatory 
stage of this disease, I have copied them as described 
by Dr. Rush. 

"The symptoms which mark its first stage, are seldom 
observed; or, if observed, they are too often treated with 
neglect by patients and physicians. I shall briefly enu- 
merate these symptoms. They are a slight fever increa- 
sed by the least exercise; a burning and dryness in the 
palms of the hands, more especially towards evening; 
rheumy eyes upon waking from sleep; an increase of 
urine; a dryness of the skin, more especially of the feet 
in the morning; an occasional flushing in one and some- 
times in both cheeks; a hoarseness; a slight or acute pain 
in the breast; a fixed pain in one side, or shooting pains 
in both sides; headacSi; occasional sick and fainty fits; a 
deficiency of appetite, and a general indisposition to ex- 
ercise or motion of every kind." 

These are, most generally, the premonitory symptoms 
of consumption; and, if proper attention is paid to them, 
before there is a confirmed cough, they will generally 
yield to such remedies as are calculated to restore tone 
and vigour to the general system. These are the care- 
ful avoidance of all debilitating causes, as intemperance, 
exposure to the vicissitudes of the weather; wet feet; 
damp beds; confinement; too thin clothing, &c. 

The use of iron in the form of filings or rust, with 
bitters, or the use of the bark, and elixir vitriol with 



OF CONSUMPTION OF THE LUNGS. 171 

attention to the bowels, and exercise, more especially on 
horseback, will generally remove these premonitory 
symptc»ns, and restore good health. It is in this stage 
of consumption in particular, that voyages to sea, or tra- 
velling will generally cure; and so will constant exercise, 
gradually increased according as the system acquires 
strength. 

Should the disease, notwithstanding our efforts to ob- 
viate it, advance, and the cough become fixed, with ex- 
pectoration of phlegm, blood, or pus, or should occasion- 
al hemorrhages occur from the lungs with increased in- 
flammation of the trachea, as manifested in the increase 
of hoarseness, an increase of debility, some difficulty in 
respiration, with a disposition to sweat at night, and an 
increase of lassitude after eating; we may now view the 
disease as arrived at the height of the inflammatory stage. 
This view of the case is applicable to both kinds of con- 
sumption, or more correctly speaking, applies to the dis- 
ease whether accompanied with scrofula or not. 

I beg leave here, once more, to give a strong view of 
my notion of the connexion between consumption and 
scrofula. Consumption is a disease sui generis, so is 
scrofula; they may and sometimes do exist together, but 
either may, and does most generally in this country, exist 
alone. Scrofula may be a predisposing cause, or may 
be roused up from its lurking place by consumption, so 
may consumption pass b"a scrofulous taint, and leave 
it undisturbed, provided it does not continue too long, 
and hence, the advantage in all cases of taking this dis- 
ease early. This also suggests another cause for cau- 
tion in the use of mercury for this disease, for this medi- 
cine will rouse up a lurking scrofula more certainly than 
consumption itself. 

I am irresistibly led into a digression here, and offer 
as my opinion that the dreadful consequences which 
sometimes arise from the use of mercury, is owing to its 
rousing up scrofula, which was dormant, and would pro- 
bably have remained so, with due temperance of habits 
generally. 

Let us not then, if we meet with those unfortunate 
cases sometimes, attribute the mischief to the abuse of 
mercury, or to the virulence of the disease, but to this 



173 OF CONSUMPTION OF THE LUNGS. 

foe in ambush Without extraordinary imprudence mer- 
cury will never produce any disease, but when it meets 
scrofula in its travels through the living system, dreadful 
consequences ensue from their meeting, and the preoccu- 
pant always comes off victorious, but not without angry 
expressions for such intrusion. 

A consumption having arrived at the verge of its first 
or inflammatory stage, as manifested by the symptom 6 
just mentioned, together with liability to getting repeated 
colds: it will now be necessary to abstain for some time 
from every article of diet but milk, in any form in which 
it can be taken best. Where the stomach does not seem 
to relish it, we sometimes succeed by trying it in every 
way, sweet, sour, new, skimmed, with its cream or skim- 
med and diluted with water, or buttermilk, or the milk 
of the goat, or ass. Where none of this will succeed, a 
little seasoning of ginger will answer, or boiling the milk 
and mixing it with flour, or well boiled rice with a little 
sugar. If none of these will succeed, gruel or sweeten- 
ed milk whey, or toast and water will answer. In short 
unless the patient is of a very weakly constitution, they 
cannot well live too low; regard may also be had here, 
to the prevailing constitution of the weather, if mortal 
epidemicks prevail of a low grade, it will be prudent to 
use a little broth or coffee. 

In all cases, mush of well mashed potatoes, Indian 
meal, or rye, or bread, and choic^fe ripe fruits may be used. 
The morning and evening air, as well as night air, is to 
be carefully avoided. Warm clothing, especially warm 
dry feet, and one or more flannel shirts must be worn. 
Nothing but milk and water, or weak cool infusions of 
pleasant bitters ought to be drank. But moderate cover- 
ing at night, and a spacious or well aired room is abso- 
lutely necessary; a hard bed at least in summer, and 
sleeping alone is best. The bowels ought to be kept 
pretty open with injections, or very mild purgative arti- 
cles, as rhubarb, or rochelle salts, or sulphur and cremor 
tartar. Bleeding once or twice a week according to cir- 
cumstances is indispensable; gentle and constant exercise 
is necessary, as well as going abroad every day during 
good weather. But in this stage of the complaint, no- 
thing can possibly be more ruinous than fatigue. 



OF CONSUMPTION OF THE LUNGS. 173 

Should the symptoms decline and evident improve- 
ment advance, this course may be continued for a few- 
weeks, but ought, perhaps, never to exceed live or six. If 
the patient seems to fall away, without any great amend- 
ment of the cough, hoarseness, night sweats, &c. this 
course must be changed, and the patient is now to be 
viewed as being in the hectick stage of the disease. 

The hectick stage as it becomes more confirmed, is af 
tended with chills, and increase of fever, great dispos - 
tion to flashes of heat after eating, with a more marked 
hectick colour of the cheeks, increased night sweats, or 
greater discharges of urine, frequent irregularity of the 
bowels, increasing expectoration, hoarseness, and cough, 
continues with increased difficulty in respiration. In 
this condition of ih& system, 1 view the debility as being 
more equalized, but of a more morbid character, for it is 
a fact, that a diet tolerably nutritious, with constant ex- 
ercise, are among the best remedies. 

He who looks for much aid in this stage of consump- 
tion frcrm medicine, will generally be disappointed. So 
soon as consumption is confirmed, and due depletion made 
by the remedies pointed out above, nothing will avail hut 
unremitting exercise on horseback, or otherwise. Should 
the patient take cold, and be affected with pleuretick or 
pneumonick symptoms, blood should be taken in small 
quantities, and repeated as may be necessary. In this 
stage a cordial and nutritious diet is indispensable: I am 
so fully persuaded that the excellent and great Rush 
carried his low diet too far, (and I judge from several ca- 
ses I have seen of his prescriptions,) that I think proper 
most solemnly to caution every person not to carry his 
low diet too far. 

Dr. Rush, in all his views of this disease, considers 
it a disease of debility: he constantly and strongly re- 
commends exercise. Surely there is an inconsistency in 
expecting a vigour and strength of constitution from 
bread and milk given to a people raised on animal food, 
&c; and, who are to be constantly on horseback. I 
would lay it down as a general rule, that so soon as the 
patient begins exercise in good earnest, either at home 
or on a journey, that the diet should comport in some 
measure with the exertion. Broth, well boiled chicken, 



1/4 OF CONSUMPTION OF THE LUNGS. 

or other light, fresh animal food; eggs, oysters, fresh 
fish, and coffee, and now and then a little very good 
wine, will be proper, and, indeed, indispensable. If 
these, or now and then getting cold, should hurry 'lie 
circulation, and augment the cough and pain of the breast, 
bleed, and repeat in small quantities, as may he neces- 
sary. If such diet disagree with the stomach or bow- 
els, a change of condiment may be useful, as a little nut- 
meg, cinnamon, ginger, &c. 

When the stomach becomes much disordered, a gentle 
emetick of ipecacuanha may be useful; but a frequent 
repetition of this remedy will impair the stomach, and 
increase the debility of the patient. I shall now pass 
on to the typhus stage. 

When the disease arrives at its last stage, there is an 
increase of all the symptoms, particularly of fever, which 
confines the patient in good measure to bed; the expec- 
torated matter becomes generally thin pus; the sweats 
increase; there is frequent severe diarrhoea, and nausea 
or vomitins.*: palpitation of the heart; faintne>iS; cold 
sweats; smalluess of the finger*, with curving in of the 
nails; respiration becomes hurried; the body wastes ra- 
pidly: thus the symptoms continue; sometimes one, then 
another predominating. A sudden rupture of an ab- 

ss, or blood vessel, or a sudden suffocated excitement 
about the trachea, leads the sufferer from a scene of dis- 
tress. Heath, with a feeble dart, severs the last strug- 
gling efforts, and kindly gives the patient a passport to 
another world. 

In this last stage of consumption, a cordial and pretty 
full diet; cordial drinks; as wine whey, coffee, chicken, 
water, punch, porter, or porter and water sweetened; 
with the use of laudanum, two or three times in twenty- 
four hours. A good drink for such patients, is a pretty 
strong infusion of iceland moss in milk, or nice chocolate; 
a little bark, or pleasant bitters, may be useful; boiled 
onions, oysters, and even beef steak, and the liberal use 
of good wine, has been found useful in this low state of 
consumption. 

But exercise must never be relinquished; if the patient 
cannot walk or ride, nor have access to a carriage, move 
him on a small carriage made for the purpose; or if no- 



OF CONSUMPTION OF THE LUNGS. 175 

thing better is at command, place bis bed on planks, and 
cany him on a wheelbarrow; if he improves, his exercise 
may be gradually increased. It now remains to make a 
lew general conclusions. 

If we are fully satisfied that no scrofulous taint exists, 
mercury may be tried at any stage of consumption; but 
it ought never to interfere, for any length of time, with, 
exercise. After the inflammatory stage is pretty well 
over, a salivation has often removed consumption in it* 
forming stage; but I have never been able to succeed 
with it after the disease might, decidedly, be said to be 
beyond the verge of jmeumonia; although I have tried 
it with every precaution, and under circumstances appa- 
rently favourable; having gone even so far as to take 
some patients to my own house. 

Upon the whole, very little is to be expected from 
mercury in this disease, or any other medicine. Exer- 
cise is the sheet-anchor and only hope in this terrible 
disease; it must be, accommodated to the strength and 
stage of the disease. It may begin with riding on a 
smooth road or floor in a carriage, the patient sitting up, 
if possible; next increasing the motion by moving faster; 
then reasonable riding at a walk of the horse, then trot- 
ting; afterwards, more constant walking, riding, running, 
dancing; and lastly, constant labour. 

I agree with Rush, that sea voyages have seldom been 
useful, unless the patient partakes of the common labour 
of managing the ship. But I feel compelled to observe, 
that I think the Doctor's views of grading exercise are 
erroneous, and likely to lead sometimes to mistakes. I 
will briefly give my own views. 

I consider every kind of swinging, sailing, rocking, 
or exposure to dangerous precipices, sedative in their 
operation, until we become accustomed to these kinds of 
motion; and, therefore, they are ouly useful, or even safe, 
where we wish to remove an inflammatory diathesis. It 
follows, that where consumpted persons were benefited 
by those modes of exercise, (and this has often occurred,} 
that they were labouring under the disease in its inflam- 
matory stage. And this kind of exercise is probably 
one of the most active and agreeable means of rehiring 
inflammatory action of a chronick nature 



176 OF CONSUMPTION OF THE LUNGS. 

It may be well to bear in mind, in the diseases of 
children and others, that these modes of exercise will 
reduce the strength rapidly, before the body can be ac- 
customed to them; and, therefore, where children are 
much reduced, they are certainly sometimes injured by 
rocking in a cradle. The rocking interrupts the func- 
tions of the lungs, and thereby increases the debility 
present. The evident tendency which rocking has to 
lull to rest, is a proof of its sedative nature. 

The next thing in point of importance, is attention to 
diet; and it is, perhaps, safer to err on the side of a diet 
too low, than run the risk of living too high, especially 
the first few weeks. When the disease is confirmed, the 
patient must, in some measure, consult his own feelings; 
but I feel full assurance in observing, I have never seen 
any advantage from a very low diet, after the disease was 
confirmed, and somewhat advanced. Blood-letting in 
every stage of consumption may be practised; but such 
patients never can bear large evacuations, and it ought 
to be reserved for the increase of symptoms, which so 
often arise from getting colds. 

Through every stage it will be advisable to keep a 
small sore over the breast-bone, by rubbing now and 
then with a little ointment of corrosive sublimate. 

In the regulation of our diet, we must always bear in 
mind, that the stomach is weak, and therefore calls for 
small, frequent meals, of the lightest kinds of food. 
Where a cordial diet is necessary, a little salted meat 
will be proper, more especially in the summer; for there 
is much disposition to diarrhoea from using fresh meat at 
this season of the year. Through every stage of this 
disease, mush and milk, or iceland moss boiled in milk, 
will be allowable. All conserves, syrups and confections, 
tend to impair the appetite; therefore they should never 
be allowed for any length of time, unless on trial mani- 
fest advantage is derived from them; a little fruit jelly 
and milk will be a better desert for a weak stomach; 
honey, if it agrees with the bowels, may be used; but it 
generally disagrees: tar- water, resins and balsams, if 
ever they can be useful, it must be in a very low state 
of the typhus stage; or, in the early stage, before any 
considerable fever has occurred. 



OF CONSUMPTION OF THE LUNGS. 177 

Persons have recovered from consumption from under 
every discouraging appearance; and therefore we should 
never wholly despair. It is our duty, while life lasts, to 
persevere in our efforts. 

I have still to observe, that a spitting of blood, or he- 
morrhage, from the lungs, calls loudly for the lancet; 
and we should never desist till we subdue that symptom; 
for it is always better to bleed from the arm than from 
the lungs. But those discharges of blood may generally 
be checked by taking freely of common table salt, from 
one or two tea spoonfuls to ttn or a dozen of dry salt, 
taken gradually, will have a speedy effect in stopping 
this discharge. 

As you value your life, never be advised to tamper 
with nostrums. When you are distressed with urgent 
symptoms, losing a little blood, or, in the advanced stage, 
a little laudanum will mitigate; but no medicine will avail 
any thing towards a radical cure, therefore place depen- 
dance wholly on unremitting exercise, and a diet accom- 
modated to the stage of the disease. 

However much chronick debility, arising from various 
causes, may predispose to consumption, I am inclined to 
believe this disease partakes, in good measure, of the 
character of an epidemick. That is, I imagine some pe- 
culiar state of the air, acting on a debilitated person, will 
excite this disease. It never is either contagious, or he- 
reditary. Unhealthy parents may leave a weakly con- 
stitution, or a peculiar conformation of the breast, &c. in 
their offspring; but all this predisposes only, and requires 
an unhealthy atmosphere to produce the disease. This 
view of the subject leads us to the hope, that by great 
care as to temperance, warm clothing, and active indus- 
try, we may often, perhaps generally, escape. 

Dr. Rush was strongly predisposed to consumption 
during a long life: he had inherited from his parents a 
strong tendency to it; but his extraordinary industry, in 
every period of his life, together with temperance, and 
great attention to clothing, &c. carried him to a good old 
age, when he dropped into his grave, amid his undimi- 
nished usefulness; from another disease. 

m 



178 OF CONSUMPTION OF THE LUNGS. 

A nervous consumption is sometimes met with: it is 
called atrophy, and was described by European authors 
under the name of tabes. This is a wasting away of 
the body, without any considerable fever or affection of 
the breast; and is probably a disease originating in the 
stomach, and pervading gradually all the assimilating 
powers of the body. I suspect it is generally accompa- 
nied with diabetes. Indigestion, languor, inward fever- 
ishness, together with a rapid w 7 asting of the body, are 
its principal symptoms. 

Treatment. Exercise here is an essential part of the 
cure; tonicks, and bark, iron, the cold bath, &c. with light 
but nourishing diet. 

Some of the chalybeate mineral waters of our country 
may be useful in this disease; but for consumption of the 
lungs, they can seldom, if ever, be safe. Where con- 
sumption proceeds from any known debilitating cause, 
it is obvious our first efforts must be to avoid such cau- 
ses; as intemperance, giving suck, &c. and endeavour to 
restore tone by tonicks, &c; but if these do not succeed 
in reasonable time, we may conclude that an inflamma- 
tory diathesis is established, and will only yield to ab- 
stemious diet, repeated small bleedings, exercise, &c. 

Nature seems to desert us in this disease, and unkindly 
leaves the patient to struggle with it, while she adds an 
almost irresistible propensity to rest. But in vigorously 
opposing this fatal tendency to inaction, we do no more 
than in counteracting her blind, or unfriendly efforts to- 
wards sleep, when pressed severely hy cold. To yield to 
her sluggish invitation in either case, is certain ruin. 
She is a kind parent, but a bad physician. She would 
carry those suffering with cold to a bed of snow, and to 
death! She would entice the suffering consumpted to 
beds of down, to scenes of sloth! and to mistaken views 
of his danger! adding to each succeeding assent, another 
down! down! until the yielding patient is no longer able, 
to oppose the rushing torrent! the harassed soul on sera- 
ph ick wings takes its flight to regions eternal. 

Let me then admonish every patient in this disease, 
to bear in mind that a disposition to rest stands in the 
same relation to him, that a disposition to sleep does to 



OF THE PERIPNEUMONY. 179 

one likely to be frozen. With might and main, then, bear 
up against so fatal a propensity! remembering that as too 
violent exertion would wear down the chilled traveller, 
and lead to equal danger with its opposite; so in con- 
sumption, by too violent exertion we frustrate the inten- 
tention in view. Exercise, must be as constant as the 
return of day; but carefully accommodated to the cir- 
cumstances of each case. 

Let all those affected with consumption, or any serious 
affection of the breast, bear in mind that warm clothing 
is of the very greatest importance; flannels should be 
worn next the skin; warm stockings and strong shoes, 
well greased, in wet weather, are also particularly ne- 
cessary. Such persons are very sensible to changes of 
the weather, and are, in general, disposed to chilliness; 
and the only safe remedy against those chills is warm clo- 
thing; being much about the fire or a stove room, is gene- 
rally injurious to such people, except the weather be cold. 

Many patients are injured by exposing themselves too 
early to the morning air; no one labouring under any se- 
rious affection of the breast should go abroad before the 
sun is about an hour high; and, even prior to going out, 
this late in the morning, should breakfast; or if the appe- 
tite is too languid, so early in the morning, a little food 
of some kind should be taken; something solid will ge- 
nerally be best, as gingerbread, or a mere taste of nice 
dried meat, with bread and butter, &c; or, if the patient 
is on a low diet, a little bread with preserve, or a little 
warm milk with a small quantity of pepper may be 
taken. 

SECTION II. 

Of the Peri-pneumony. 

This disease is an inflammation of the lungs, very 
much resembling a pleurisy, being attended, however, 
with a greater difficulty of breathing, less pain or stich- 
es. It often succeeds obstinate, or improperly treated 
cases of croup. It generally commences with febrile 
symptoms, as chills, and heat, some cough, and some- 
times pretty free expectoration attends with streaks of 



180 OF THE FERIPNEUMONV. 

blood; the urine is apt to be unusually high coloured. 
It is sometimes complicated with pleurisy. There is 
also a lower grade of peripneumony, which has been 
called the bastard, or peripneumonia notha. All these 
diseases, or rather symptoms, are one and the same thing, 
differing only in grade; pleurisy being the highest, and 
the bastard peripneumony, the lowest grade of this affec- 
tion, of the chest; and they are now generally all spoken 
-of under the term pneumonia 

In our efforts at curing this disease we are to use the 
lancet, more freely, as the case approaches nearer the 
pleurisy, in its appearances, while in the low grade of 
the bastard peripneumony, we must bleed with great 
caution, and sometimes not at all. 

In an active peripveumony, as manifested by general 
fever, chills, difficult respiration, cough, spitting of frothy 
matter, streaked with blood, a full or corded pulse, &c. 
we ought to bleed, and according to the constitution of 
an adult person, take from ten to sixteen ounces of blood, 
should this not relieve, or should it increase the symp- 
toms, which is often the case, we must repeat the bleed- 
ings frequently, until the symptoms yield. In this stage 
of the case we may content ourselves with opening the 
bowels with mild purges, as senna and manna, salts and 
manna, or roch^lle salts, or even injections, provided we 
bleed according to the symptoms. If this treatment re- 
lieves the patient, which is generally the case, we may 
leave the case to nature, so soon as free respiration, con- 
siderable abatement of the fever, and the disappearance 
of bloody streaks in the spittle, with a more regular and 
softer pulse has taken place. Mild warm drinks, as 
milk whey, weak teas, barley water, apple water, or 
milk and water, must constitute the only beverage. Wine, 
spirituous drink, or animal food, must not be touched till 
the convalescence is well advanced. 

If the case becomes protracted, blisters will be neces- 
sary, applied over the breast; the spirits hartshorn in 
doses of ten to twenty drops in a glass of cool water, or 
a decoction of seneka snakeroot, will be necessary, re- 
peated every two hours, or tincture cantharides may be 
given till it excite slight strangury. 



OF THE PLEURISY. 181 

In low cases, where the pulse is weak, and does not 
rise after bleeding moderately, or in very debilitated ha- 
bits, without bleeding at all, we should give calomel in 
doses of five grains twice a day, and restrain its opera- 
tion on the bowels, if necessary, with a few drops of lau- 
danum, given with an equal quantity of spirits harts- 
horn. A large blister should be applied over the 
breast, and if the case is obstinate, it must be repeated 
as soon as it dries up. The tincture of cantharides 
should be given till it excite strangury, if the symptoms 
do not abate sensibly after the blister. 

The decoction of seneka snakeroot may now be given 
with advantage. The bowels should be regular, but 
purging is perhaps never necessary, and often unsafe. 
A little wine whey may be allowed in this low grade 
of the disease, chicken broth, chocolate, oysters, &c. in 
small quantities. 

When convalescent, the patient may use the bark and 
-elixir vitriol to advantage. Great care must be taken to 
avoid damp weather, or damp clothes, or rash meals, for* 
this disease is apt to return without much care. 

Peripneumony of a low grade is a very dangerous 
disease, being apt to terminate in suffusion of tough 
phlegm, into the vessels of the lungs, which brings on 
what Dr. Rush calls suffocated excitement, and destroys 
the patient; the free use of blisters is a principal remedy, 
and in dangerous cases I would recommend the oint- 
ment of corrosive sublimate in preference to the common 
blisters which act much more slowly. In active cases 
of this disease, ipecacuanha and calomel, given so as to 
excite slight nausea, will be advisable. 

SECTION III. 

Of the Pleurisy. 

The reader before he proceed to prescribe in a pleu- 
risy, should turn to the article on peripneumony. A ge- 
nuine pleurisy is not found in practice, except among the 
athletick people of healthy neighbourhoods. This dis- 
ease is generally brought on by rash exposure, to cold 



182 ' OP THE PLEURISY. 

op night air, fatigue, too thin clothing, and especially 
neglecting to put on clothing, which may have heen 
uncomfortably warm during the day. Nothing can be 
more improper than neglect in this respect; every la- 
bourer should put on his hat, coat, shoes, &c. as soon 
as he leaves off work and feels cooler. 

Chills and acute pain or stitches, generally announce 
the attack of pleurisy; these stitches soon become into- 
lerable, shooting towards the shoulder blades, or among 
the ribs, particularly on drawing breath. The breath- 
ing is confined and difficult, the pulse is full, strong and 
tense. A cough, often slight at the commencement, but 
increases as the disease advances, with some spitting,, 
generally streaked with blood. 

Treatment. — We must bleed largely and repeatedly 
to subdue a violent pleurisy, and in general, the benefit 
from bleeding will be greatest, from abstracting the 
blood suddenly; we should make a large orifice and 
draw in the case of a stout man, from sixteen to twen- 
ty-four ounces, or in other words, from one to three 
pints of blood should be taken at the first bleeding, 
afterwards they should be less, but always large, and 
repeated twice a day till the symptoms abate. 

If the case is obstinate, after plentiful bleeding, we 
may apply a large blister over the breast; give spirits 
hartshorn in small doses every two hours, or the decoc- 
tion of seneka, with smail doses of calomel. Tartar 
cmetick dissolved in a good deal of water, or ipecacu- 
anha in small doses, so as to excite a slight nausea 
without vomiting, may be given during the inflammato- 
ry symptoms: two grains of tartar emetick, in a pint of 
water, will form a good febrifuge in this disease. The 
bowels should be kept open, but purging will not have 
much effect. 

The lowest possible diet should be used, such as 
toasted bread soaked in water; a roasted apple, or a 
little very weak tea with bread. For drink, milk and 
water, thin barley water, apple water, toast and water, 
thin flaxseed tea with a little liquorice, or milk whey, 
or cremor tartar water, may be used freely, 



OF THE CR0l'l\ OR HIVES. 183 

.^0011 as the cough, fever and stiches abate, leave the 
to nature, taking great care not to return to cordial 
or heating drinks, or animal food, but with the utmost 
ion. 

Should this disease terminate in an obstinate cough, 
which will seldom be the case if it is properly treated, a 
perpetual blister should be applied to the breast: and if 
we are well assured no scrofulous taint exists, we should 
have recourse to calomel, so as to bring on a soreness of 
the mouth, and continue it for a period, of from one to 
two or three week*, as may be necessary, avoiding a sa- 
livation, by quitting the calomel occasionally. Every 
person rising out of a pleurisy, must dross warmer than 
usual, and wear flannel next the skin. 

SECTION IV. 

Of the Croup* or Hives. 

Children, under seven years, are most subject to croup: 
it sometimes attacks at a very early period of life, and 
becomes in some measure habitual: recurring in some 
children, at times, in form of a common cold: but more 
frequently very suddenly. Children who are put to bed 
apparently quite well, or. perhaps, sometimes slightly 
indisposed, are liable to be attacked with this disease in 
a violent and dangerous manner: so that it becomes the 
absolute duty of those present, to rise and administer 
some suitable remedy, which should always be at band: 
for to wait till morning would often be to wait till the 
case is beyond all hope. 

It is an unquestionable fact, that no disease is so com 
pletely under the control of medicine, if taken in in- 
forming stage: nor is there one more mortal, when ne- 
glected or wrong treated. This disease may be known 
by a peculiar hoarseness, which, with the difficulty of 
breathing, plainly shows that there is some obstruction in 
the windpipe. This peculiar hoarse, suffocating sound, 
attends every spell of coughing, and gives a carious 
chokiug-like sound to the act of breathing. So charac- 
tfcristick i- this hoarseness, that a person who ha<? seen 



184? OF THE CROUP, OR HIVES. 

croup but once, could scarcely mistake it afterwards. 
The face has always an unpleasant staring appearance: 
the difficulty of getting breath is so great, that such pa- 
tients are extremely restless, and labour with all the ef- 
forts which they can command, over the muscles of the 
belly and chest. 

When the disease is violent, it is called bold, or bowel 
hives. Sometimes it is attended with eruptions or pim- 
ples on the body; but, these have no essential connexion 
with the disease. When this disease is discovered at 
an early stage, a vomit of white vitriol, ipecacuanha, or 
antimonial wine, provided it operates freely, is sure to 
check the disease. If it does, it is only necessary to 
guard, a few days, against cold; not, however, denying 
the privilege of going abroad, if the weather is good. 

A decoction of seneka, given three or four times a day, 
may be useful in removing the slight remains of the dis- 
ease. If the case yield'not to a brisk vomit, as above 
mentioned, calomel should be given in large doses: from 
five, to twenty grains, may be given, twice a day. At 
the same time, if the vomit has not checked the com- 
plaint, bleeding must be had recourse to, as an indispen- 
sable remedy; and should be repeated as often as suftV 
cation seems threatening. 

If the case becomes protracted, the use of the calomel 
must be continued; blisters may be applied, and a strong 
decoction of seneka given. But I have seen more bene- 
fit derived from the application of linseed meal, or bread 
and milk poultice, with flaxseed boiled in it: this is to 
be applied over the whole breast, and down to the navel,, 
as warm as it can be reasonably borne. 

Weak onion tea, or milk and water, will be proper 
drinks. No cordials, nor animal, or even solid food, 
should be given, till the patient is quite recovered. And 
even when well, in children who are subject to this com- 
plaint, full meals are among the most frequent exciting 
causes of the croup. 

Croup is sometimes protracted so as to continue for 
several days; it will be necessary in such cases to give 
the calomel in smaller doses, after the second day of 
using it. The warm balh is sometimes useful in the 



OF A COMMON OOLD. 185 

I the disease, or after free evacuations. In very 
kly. delicate children, the treatment of this di-ease 
vaay be most safely trusted to large doses of calomel. 

I caunot conclude this article without cautioning the 
people of the country, in the most solemn manner, against 
extremely dangerous practice recommended by Bu- 
chan. in his Domestick Medicine, How far this practice 
may answer in England. I will not undertake to say: but 
of all things it would be the most dangerous, in the mid- 
dle, or northern states. I do not believe one in fifty 
would escape from a severe spell of croup, under such 
treatment. 

It is even questionable whether the practice will app \ l ~ 
to England generally, for the celebrated Darwin call * 0] J 
a pleurisy of the windpipe: a name, at once expres ieraA 
of his idea of the disease, and of a depleting plan of tr 
ment. Many English authors, of the highest respe- 
bilitv. consider croup a disease hishlv infiammato. 
Cullen. Thomas. Wilson, <£c. are quite decided o. 
this subject, against the opinion of Buchan. 



section v. 
Of a Common Cold, 

All those affections which eo by the name of common 
colds, are accompanied with some feverishness, however 
slight: and. therefore, when we are conscious of bavins: 
caught cold, as manifested by obstructed watery nose; 
inflamed eyes: sneezing: more or less lassitude, or want 
of appetite, or a slight cough: it will be sufficient in 
general, to avoid night, and morning, and evening air; to 
dress a little warmer, bathe the feet going to bed: and 
drinking a little warm tea. and using a reduced diet, re- 
gulated according to the violence of the case ? will be ad- 
visable. 

In severe colds, a total abstinence for a day or two. is 

a sovereign remedy with many persons. But unless some 

disease arises from such colds, the abstinence should never 

be continued long. If a cough becomes troublesome. 

p a little opening medicine, and if that does not afford 



186 OF INFLAMMATION OF THE STOMACH. 

relief, bleeding may be necessary. If much fever or 
cough arise, it will be necessary to look at the sections 
on peripneumony. and on pleurisy. 

Many people on taking cold have recourse to hot stews; 
they ought never to be used until you are well convinced 
no fever is lurking in the body, otherwise death may be 
the forfeiture, for many of our most malignant fevers, &c. 
commence like a common cold. A syrup of lemons, or 
of strong pleasant vinegar, will often be useful, and in 
old cases, a syrup or other preparations of horehound, 
or a conserve of Indian turnip, with regular exercise, 
and avoiding wet beds, wet feet, or exposure in damp 
leather, will restore the health, 
gu. 

* ne • SECTION VI*. 

ma . Of Inflammation of the Stomach, or Gastritis. 
ea? 

r One of the most infallible signs of inflammation of the 
stomach, is severe pain on taking food, or drink, toge- 
ther with some fulness and pain from pressure being 
made on the part: a constant symptom of this disease is, 
a small, quick, and tense pulse; nausea, or vomiting is 
common on taking food or drink. Faintness, cold ex- 
tremities, difficult breathing, &c. are also generally pre- 
sent. A hiccup is an unpleasant symptom. In all the 
cases of this disease which I have seen, neither food, nor 
drink of any kind could be borne, until the disease was 
much abated. Indeed I think it highly probable, diges- 
tion is wholly suspended during active inflammation of 
the stomach, and, therefore, no advantage can arise from 
taking food, or even drink, except in very small quan- 
tity, for the purpose of lubricating the surface. 

A spoonful of milk and water, or a thin decoction of 
slippery elm bark, or thin gruel, taken in quantities of a 
single table spoonful, and repeated frequently, is all that 
ought to be given by the mouth; no medicines, food, or 
drinks, in any considerable quantity, can be given with- 
out the utmost hazard, and no benefit can possibly arise 
from it. Injections of a mild opening quality should be 
given frequently, and when the bowels are well opened. 



OF INFLAMMATION OF THE INTESTINES. 187 

injections of broth, containing each a few grains of calo- 
mel, should be given. But the patient's safety depends 
principally on repeated bleedings, till we raise the pulse, 
and relieve the pain, and the soreness, which arises from 
pressure. 

Few diseases deceive us more in the appearance of 
the pulse than this, and few require a more free use of 
the lancet. In all cases, a large blister should be ap- 
plied over the stomach. After free bleeding, if the pain 
and other symptoms have not evidently abated, the warm 
bath should be used, and repeated according to circum- 
stances. When the disease is checked, it requires great 
care in returning to the usual diet and drinks. Xo sti- 
mulants or solid harsh food ought to be ventured on for 
several days, nor indeed till the strength of the general 
system is pretty well restored by means of exercise. 

SECTION VII. 

Of Inflammation of the Intestines, or Enteritis. 

This affection is attended with a constant severe pain 
of the bowels, eructations of wind, nausea, quick, tense, 
small pulse: obstructed bowels: and sometimes with a 
vomiting of the feces: great debilitv: anxietv. In this 
disease we must bleed freely, a ;| repeat according to 
circumstances. A large blister .sZould be applied: mild 
injections must be given frequently, or what is better, a 
large quantity of warm water: a gallon or two may be 
thrown up from a large bladder as rapidly as possi- 
ble. Soon as free depletion has been made, calomel in 
doses of five to ten grains, should be given, combined 
with a little opium, and repeated every six hours, till 
there is an abatement; should none of these remedies 
succeed in the course of the second day, the warm bath 
should be had recourse to. The diet must be light, 
such as milk, light broth, well boiled meats, oysters, 
gruel, rice well boiled, &c. for some time after the dis- 
ease is checked. During the disease the patient should 
avoid food and drink, except chicken water, milk and 
water, slippery elm bark water, or other light mucilagi- 
nous drinks. 



188 OF INFLAMMATION OF THE KIDNEYS. 

In distinguishing this disease from colick, regard 
should principally be had to the circumstance of extreme 
debility, which always accompanies it; while in colick 
the patient is seldom so sensible of weakness; nor is the 
pulse so much disturbed in the colick. All these in- 
flammatory affections of the viscera are highly danger- 
ous, and, therefore, advice should always be had, where 
it is practicable. 

SECTION VIII. 

Of Inflammation of the Kidneys, or Nephritis, 

■0 

An inflammation of the kidneys may arise from vari- 
ous causes; but its most common known causes are calcu- 
li, formed within them; the extravagant use of cantha- 
rides, or spirits turpentine; but most frequently I have 
met with this disease, as arising from violence done the 
parts, by blows, falls, &c. There is generally a severe 
dull pain in the loins, extending down one or both thighs. 
Little urine, sometimes bloody, but at other times pale. 
It is often attended with nausea or vomiting, and the 
pain, in severe cases, seems to affect the abdomen with 
an inflammatory diathesis; and general fever is a fre- 
quent concomitant. 

In this disease we must bleed with freedom, in healthy 
habits; give cooling no&tilaginous drinks, as slippery elm 
bark water, an infusion of quince seed, or water melon 
seed, or milk and water, taken cool. The bowels should 
be opened with emollient injections; and these assisted in 
their operation with reasonable closes of calomel: no 
drastick, or saline article should be used: nitre, cremor 
tartar, &c. must be avoided. The safest article of this 
class of medicine, is phosphorated soda. In severe ca- 
ses, blisters to the back, produced by the application of 
the ointment of corrosive sublimate, w?ll be advisable. 
Cantharides must not be applied on any account; it might 
be productive of much mischief. A very low diet is es- 
sential. 

Should this treatment not remove the complaint in five 
or six days, we must omit bleeding, and content our- 



OF INFLAMMATION OF THE BLADDER. 189 

selves with keeping the bowels open with injections of 
mild articles; rest, and moderate diet, and await the issue 
of suppuration, which will probably take place; even 
now, mucilaginous drinks are necessary; small quantities 
of laudanum may be given. Cordial and saline articles, 
must be avoided with care, and the patient put on the 
use of the uva ursi: from twenty to sixty grains may be 
taken three times a day, in milk, or water; and the pa- 
tient should live on a milk diet. Exercise in a carriage 
will be most suitable. 

SECTION IX. 

Of Inflammation of the Bladder, or Cystitis. 

Inflammation of the bladder may be known by more 
or less fever, pain and swelling in the lower part of the 
belly; frequent difficult and painful discharges of water; 
tenesmus or inclination to go to stool. Bleeding will be 
necessary, according to circumstances, and must be re- 
peated till the severity of the symptoms abate. The 
Dowels should be freely opened with mild injections, as 
linseed tea, slippery elm bark water, milk and water, or 
even warm water. Castor oil, magnesia, or calomel, 
may be given to open the bowels; but no saline, nor diu- 
retick articles, are admissible. In obstinate cases the 
warm bath may be useful, after suitable bleeding. 

Should the case become protracted, we must continue 
the mucilaginous drinks, and use the uva ursi; from 
twenty to sixty grains, three times a day, may be taken 
in milk or water, as may be most agreeable. It is essen- 
tial in this disease to encourage a perspiration, by suita- 
able clothing, and avoiding sudden changes of tempera- 
ture; but no heating sudorificks can be used, without 
much danger. 



190 OF INFLAMMATION OF THE DIAPHRAM, &C. 



SECTTON X. 

Of Inflammation of the Diaphram, or Paraphrenias.^ 

This disease is attended with an acute pain low down 
in the breast; particularly severe when we let in or pass 
out the breath: this induces the patient to bold in his bel- 
ly, and breathe frequent and feebly. These symptoms 
are generally attended with, and much aggravated by, a 
cough and frequent sneezing. Every effort of the body 
augments the pain; as going to stool, taking food, &c. 
An unpleasant grinning of the face is often present; and 
in severe cases, delirium. 

Blood-letting is the principal remedy in this disease; 
the bleedings must be pretty large, and frequently re- 
peated. This disease will frequently require more fre- 
quent bleedings than the pleurisy; but we should never 
make them so large. The free use of purgative injec- 
tions is indispensable. Nausea should be slightly kept 
up, after pretty free bleedings, by the use of very small 
doses of ipecacuanha. 

The diet must be low and thin; and the drinks cool, 
and of the mildest kinds. It is particularly necessary, 
in this affection, to remain as quiet as possible. Purging 
medicines may also be used to advantage; but I must re- 
peat, that in the height of this complaint the patient 
should scarcely move, and depend on the lancet. In ob- 
stinate cases, a blister should be applied over the part 
affected. 

SECTION XI. 

Of Inflammation of the Peritoneum, or Peritonitis. 

This affection maybe known by an acute pain through 
the abdomen, attended with extreme soreness when pres- 
sure is made on the part. Where this inflammation runs 
high, the patient can scarcely bear the bed-clothes; there 
is more or less fever, and short hurried breathing. This 
disease most commonly arises from wounds, or ruptures; 
and is often attended with great danger. 



OF INFLAMMATION OF THE LIVER. 191 

111 all wounds of the abdomen, large anodynes of so- 
lid opium should be given, which will go far to prevent 
this disease. But, after inflammation lias come on, opi- 
um would be highly dangerous. Repeated bleedings, the 
free use of mild injections, and copious evacuations from 
the bowels; for which purpose, castor oil, calomel, salts, 
rochelle salts, or senna and manna, may be used. Large 
quantities of warm water may be injected into the bow- 
els, and fomentations applied outwardly. 

SECTION XII. 

Of Inflammation of the Liver, or HejJatitis. 

Inflammation of the liver is less distinct in its symp- 
toms, at least to an unskilful person, than that in the 
other viscera. It is commonly attended with dull, severe 
pain, in the right side of the belly; more especially when 
the patient moves suddenly, or when pressure is made 
on the part. A fulness is often discovered, particularly 
on feeling up under the false ribs. There is some fever, 
some difficulty of breathing; and often a short dry cough. 
A dull pain extends up about the shoulder of the right 
side, very often. Sometimes symptoms of jaundice are 
present. When the inflammation is situated on the upper 
edge of the liver, a pain and soreness on pressure is felt 
over the stomach, or just below the pit of the breast. 
Frequently, however, this disease is only discovered at 
an early stage, by pretty firm pressure on the part; or by 
an inability to lie on the opposite or left side of the body* 
The pulse is most commonly not very much affected. 
This organ is so essentially different in its organization, 
and connexion with the circulating system, that we have 
no cause for wonder if we find the symptoms less distinct; 
and the treatment materially different. 

It may be remarked of the liver, that although it bears 
some resemblance to the lungs, in having a great many 
blood vessels, yet, those of the lungs, are composed of 
an equal number of arteries and veins, while those of the 
liver are almost wholly veins. The circulation through 
the liver is venous, slow, and I might almost say cbymi- 



19£ OP INFLAMMATION OF THE LIVER. 

cal, or attractive, for, its arteries are extremely small, 
and few, barely sufficient to give life to its substance; 
while the great tissue of veins carry through the venous 
blood, without any well marked propelling force; and as 
it passes along, the bile is secreted from the dark blood, 
collected from the other viscera, kc. 

In this disease we must bleed pretty freely at the com- 
mencement. The bowels should be well opened with 
injections. Then, a large blister may be applied, over 
the part affected. After which, the cure may be princi- 
pally trusted to the use of calomel and opium. Calomel 
may be given in doses of from two to five grains twice 
a day, combined with one or two grains of opium for 
each day. The abdomen, more especially over the right 
side, and stomach, should be rubbed with mercurial oint- 
ment. If the pulse remains active, with some pain, or 
much cough, we should repeat the bleedings. Warm 
fomentations which are ofteu useful in other inflammations, 
are never allowable in this. They increase the risk of 
suppuration, a frequent consequence of imflammation of 
the liver. 

Should the case prove obstinate, we must persevere 
with the mercury until a salivation is produced; and 
keep it up until the case yields, which will very gene- 
rally be the case, in persons of temperate habits, provid- 
ed the case has not been neglected, or improperly treat- 
ed, in the early stas;e of it. Should the disease con- 
tinue after a reasonable continuance of the salivation, 
we may view the disease as settled into scirrhus, and no 
longer under the control of medicine. 

I have seen many cases of suppuration in the liver, 
which pointing outwards, were opened low down near 
the back; and one case, where an abscess on the upper 
edge of the liver pointing outwards, was opened above 
the navel: most of the cases I have seen, were children; 
and they all recovered. If we are even certain suppu- 
ration has taken place in the liver, we are by no means 
to apply poultices, or fomentations; their use is extreme- 
ly doubtful, if not really dangerous. Fever must be kept 
down by the common remedies for fever: mercury can 
no longer be useful. The patient must be kept quiet: 



OF INFLAMMATION OF THE BKAIX. 193 

and await the suppuration. A skilful practitioner must 
always be called; or, if it is possible such a thing is not 
obtainable, a very small poultice of bread and milk may 
be applied for a day or two, over the prominent part, 
and then a puncture made with a common thumb lancet. 
But rn all cases, it must be well ascertained, by feeling 
with the finger, that pus is actually formed, and lodged 
superficially, before we make such puncture: and in all 
doubtful cases it is best to wait till we are certain. 

Through the whole treatment of this disease, the pa- 
tient must be kept on a very low bland diet; as well boiled 
rice, milk, buttermilk, with wheat or rye mush; or well 
mashed potato, a roasted apple; very weak tea, with 
bread, &c. For drink, mucilaginous articles alone 
should be taken, as milk and water, barley water, slip- 
pery elm water, &c. No saline or drastick articles 
should be taken, either in drink, food, or medicine; all 
cordials or animal food would be poison for such patients. 
After the disease is removed, in delicate persons, or 
those of intemperate habits, the nitrick acid should be 
used pretty freely for some time. 

SECTION XIII. 

Of Inflammation of the Brain, or Phrenitis. 

Phrenitis is generally attended with symptoms of 
violent inflammatory fever; but -as in inflammatory fevers 
we often meet with a depressed small pulse, so, in vio- 
lent cases of inflammation of the brain, we often find the 
same kind of small tense pulse. This is supposed to 
arise from a more immediate affection of the substance 
of the brain, while the more active pulse, is considered 
an evidence of an affection of the membranes. They are 
equally dangerous, for if the inflammation of the sub- 
stance of the brain destroys more suddenly, by an exhaus- 
tion or destruction of the brainular energies; inflammation 
of the membranes, by pouring out watery congestions, is 
sure ultimately to produce the same effect. 

But after all, inflammation can probably never exist to 
any considerable amount, without affecting both the mat* 
25 



194 OF INFLAMMATION OF THE BRAIN. 

ter of the brain and its membranes. This disease is 
most generally known, in this country, by the name of 
pleurisy of the head: a name well chosen, from the 
strong resemblance in the proper treatment between it 
and a pleurisy, properly so called; in addition to symp- 
toms of severe fever, there is violent pain in the head; 
intolerance to light, and loud sounds; tinkling in the 
ears; delirium, sometimes low and muttering, at other 
times outrageous; violent beatings of the temporal arte- 
ries, and those of the neck; flushings of the face; dilated 
pupils, or very much contracted; costiveness; inability to 
sleep. 

In country practice, I have generally found it con- 
nected with inflammatory affections of the breast. This 
disease is sometimes brought on by exposure to the sun; 
e pecially when the person has undergone fatigue, or 
has been exposed to the cool night air: this is called a 
stroke of the sun. 

In the treatment of this disease, we must generally 
bleed largely; but regard must always be had to the pa- 
tient's constitution; and to the constitution of the weather; 
it often attends the low grade of typhoid fever, or bas- 
tard peripneumony, of our country: and large bleedings 
in such cases would be fatal. I shall first point out a 
suitable treatment for a genuine simple inflammation of 
the brain. We must bleed largely and frequently; 
give the most active purgatives, as jalap and calomel, 
or calomel and aloes- — purgative injections. Constant ap- 
plications of cold vinegar and water to the head; strict 
quietness: cooling drinks, of nitre or cremor tartar, tam- 
arinds, &c. A total abstinence from solid, or cordial, 
or animal food: lay the head high; avoid strong light, 
or much talking, by the patient, or others. Leeches, or 
cupping glasses about the head, on parts first scarified: 
or the temporal artery should be cut, and suffered to 
bleed freely; this is attended with no danger, and will 
cease bleeding on a moderate pressure being applied. 

On the other hand, should delicate weakly persons be 
affected with this disease; or should it succeed other 
diseases, which have reduced the patient much: or should 
we have well grounded fears, that the patient is also af 



GENERAL OBSERVATIONS, &C. 195 

fected with an epidemick of a low grade; we must bleed 
from the arm with great caution, if at all. Stimulant 
purging injections, as salts, or a decoction of senna, with 
a very little aloes, may be given; or calomel and aloes, 
may be given by the mouth, so as to purge pretty freely. 
Blisters should be applied on the neck; and sinapisms to 
the feet. Cupping and leeches, should be used freely, 
about the head; and if these rouse up a more inflammato- 
ry set of symptoms; we must bleed cautiously from the 
arm, or open the temporal artery. Should the symp- 
toms not abate speedily; the head should be shaved, 
and a blister applied over the scalp; this should never 
be delayed beyond the second day; and in severe cases, 
it would be best to apply it at first. 

In those low cases, calomel may be given in small do- 
ses; a little light vegetable food should be taken if the 
appetite call for it. A little coffee, or weak chocolate, 
given in very small quantities at a time, may be allowed; 
but it would always be best to wait a day or two, be- 
fore we venture on any thing stronger than toast water^ 
milk and water, &c. This is a dangerous disease, and 
must be promptly treated, or it will soon terminate in 
death, or dropsy of the brain; a disease that is wholly 
beyond our reach, after it is fully formed. 

SECTION XIV. 

General Observations on Visceral Inflammation, 

A very generally received opinion of inflammation, is, 
that it terminates in three ways. 

1st. By resolution, or scattering. 

2d. By suppuration. 

3d. Gangrene, or mortification. As it respects in- 
flammation in muscular parts, this is nearly correct; and 
sufficiently points out its Consequences. But in exam- 
ining carefully into inflammation of the viscera, or inter- 
nal organs, we find great variety, and each organ having 
a peculiar termination of its inflammation. I shall brief- 
ly enumerate the most remarkable. 



196 GENERAL OBSERVATIONS OX 

Inflammation of the lungs, seldom terminates in gan- 
grene, or mortification: but in suppuration, called a vo- 
mica; in effusion; in clironick inflammation, as consump- 
tion; and sometimes in what Dr. Rush has called suffo- 
cated excitement; in which case, he supposes the excite- 
ment of so high a grade, as to destroy life, before the 
common appearances of inflammation occurs. I am dis- 
posed to attribute those cases to an affection of the brain- 
ular matter itself. John Bell, has given it as his opin- 
ion, and I concur in the opinion, [See observations 
on the brain,, in the preceding part of this book,] 
that a matter resembling the madullary part of the 
brain, accompanies the nerves throughout the whole 
body. I consider this kind of inflammation or ex- 
citement as operating on this nervous matter, and it is 
sometimes situated in the brain of the head; in the sto- 
mach; intestines; heart; and, perhaps, sometimes affect- 
ing the whole system. Cases of it are often found in 
the croup: many dissections of patients who have died 
of cynanche trachealis, Avith the most inflammatory ap- 
pearances before death, exhibited no marks of inflamma- 
tion after death. This kind of affection seems to differ 
from common inflammation attended with error loci, or 
congestions; in this, that while pain, fever, and suppura- 
tion, attend the latter; the former is occasioned by an 
overwhelming stimulus, which destroys the living prin- 
ciple at once. 

I am aware, however, that we might often be mista- 
ken, were we to judge alone from the circumstance of no 
marks of inflammation being found after death; for the 
vessels may empty themselves from congestions of blood, 
&c. in the very struggles of death. But the many cases 
which put on inflammatory appearances, and which ter- 
minate before the usual course of inflammation, plainly 
shows, that something like what I have hinted at, often 
occurs; and the liver is probably the only organ exempt 
from tliis kind of brainular inflammation. 

Effusion into the lungs, when the body is very low, is 
a most dangerous symptom; and as it is always the con- 
sequence of inflammation, we should endeavour by 
prompt treatment to arrest this fatal tendency. 



VISCERAL INFLAMMATION. 197 

Inflammation of the stomach, is most likely to termi- 
nate in mortification; sometimes in scirrhus: that of the 
bowels, in introsuseption, or one part of the gut slip- 
ping into another, and thus producing strangulation and 
mortification; in chronick inflammation, or in little tu- 
mours. 

Inflammation of the uterus, is liable to terminate in 
chronick inflammation, mortification, or scirrhus: that of 
the liver, in suppuration, torpor, chronick inflammation, 
and scirrhus: that of the brain, in congestions of water 
or blood; producing dropsy or apoplexy, insanity, con- 
vulsions, or epilepsy. Those different consequences of 
visceral inflammation are pointed out to show, that not- 
withstanding all inflammatory affections are, in a gener- 
al view, to be treated on the same principles, or in other 
words, although evacuations, rest, abstinence, free dilu- 
tion, with mild, weak, cool, or tepid drinks, &c. are the 
leading articles, there still is an absolute necessity for 
referring to the treatment laid down for each viscus or 
organ. 1 am met here by an opinion which I heard the 
illustrious Rush make in one of his lectures; that in our 
efforts for the removal of inflammation of the chest, we 
could obtain little aid from purging; that the lancet 
alone, would arrest such affections with that prompti- 
tude which is essential; while, in inflammation of the 
head, severe purging seemed more especially suited; and 
that, although the use of the lancet was indispensable, 
without purging we could seldom succeed to our wishes. 

Having now completed my observations on visceral 
inflammation, with all of which the general system sym- 
pathizes, I have one further remark to make; and then 
shall proceed to describe a set of diseases, principally 
characterized by local inflammation, but of a different 
kind, and accompanied also with general febrile symp- 
toms. 

In examining patients labouring under visceral ob- 
structions, we sometimes meet with the humbling fact, 
that such is the force of the disease, that the organ prin- 
cipally affected is unable to express its suffering; while 
a neighbouring one, but slightly affected, shall sympa- 
thize, give pain, and thus lead us from the real seat of 



198 OF THE ERYSIPELAS, 

the disease; this is most easily seen in the sympathetick 
affections of the stomach, and where the brain, kidneys, 
&c. are affected: other sympathies, much less known, 
sometimes occur in the bladder, and other organs. These 
should induce us to examine our patients daily; and al- 
ways in visceral affections, feel over the chest and abdo- 
men, firmly, so as to be certain our views are just. 

It may not be much out of place here, to remark, that 
abscesses on the upper part of the liver, have often found 
their way into the lungs, and were thus carried upwards, 
and discharged by expectoration. I have known one 
case of long standing, and consumption has not follow- 
ed.* 

Lastly. In all suppurations of the viscera, where the 
discharge is great, we must have recourse to tonicks, as 
bark, the acids, bitters, light nourishing diet and drinks, 
or the patient's strength will fail. 

SECTION xv. 

Of the Erysipelas, or St. JLnthomfs Fire. 

This disease is seldom dangerous, unless symptoma- 
tick of some other disease; but when it has once affect- 
ed a person severely, they are very liable to new at- 
tacks on getting slight colds, or using cordial or stimu- 
lant articles. It most commonly attacks adults; but 
children are also frequently affected with it. Common 
precursors of fever, as chills, &c. generally usher in 
erysipelas. Sick stomach, or vomiting attends, with 
headach, backach, heat of the skin, restlessness, quick 
tense pulse, and some difficulty of breathing. If it is 
not preceded, or accompanied with a swelling and red- 
ness of the face, by the second or third day, the face 
swells; the eyes are closed; pimples or watery pustules 

* It may not be amiss to remark that, Larrey, an eminent 
French army -surgeon, has recorded several cases, where, on dissec- 
tion, an opening was found through tire diaphragm into the lungs, 
of patients who died of affections of the liver. 

I mention these cases because the possibility of such an occur- 
rence has been denied by some physicians,. 



or st. Anthony's fire. 199 

appear, which often extend to the breast, and even over 
the whole body; these are at length filled with yellow 
pus, or matter. 

There is also another kind of erysipelas, which might 
properly be called the dry: it comes on suddenly. The 
first notice of it is an itching and heat in the skin, which 
rises up all over the body, even among the hair of the 
head, in lumps or welts. It is often attended with diffi- 
cult respiration, which sometimes amounts almost to suf- 
focation. The itching, and smarting, is sometimes so 
intolerable as to distract the patient, and in a few mi- 
nutes continuance, is almost more than human nature 
can bear; yet, I have never seen it prove fatal; it gene- 
rally goes off almost as suddenly as it came on. This 
has been called nettle rash; and, in the country, very 
improperly, hives, which is a very different disease. 

The best remedy in this kind of erysipelas, is to rub 
over the body smartly with flour, and rye flour is reck- 
oned the best. Give an emetick of antimonial wine; af- 
terwards, a little cooling physick may be necessary. 

The common erysipelas, has been also called wild 
fire, &c. Small repeated bleedings with cooling purga- 
tives, and injections; cooling drinks, containing cremor 
tartar, or a little nitre; or very small doses of salts, as 
two drams twice a day, with a little ipecacuanha; and 
strict abstinence, will generally remove this disease. If 
it has not been opposed in time, gangrene will sometimes 
follow; in those cases the bark should be given freely, 
and the parts washed with a mixture of equal parts, 
spirits camphor and tincture tolu; or camphorated 
spirits and sweet oil, shook well together; and if the 
symptoms do not amend in a few hours, a large blister 
must be applied. 

During the early or inflammatory stage of the erup- 
tion, we should by no means apply any repelling washes, 
or ointments; the first, may repel the inflammation to the 
brain or lungs, which is a very common occurrence; and 
the latter, is apt to leave ulcers; which are sure to mark 
the face. The only thing which should be applied out- 
wardly, is dry flour, or finely powdered sta ch, or pre* 
pared chalk. 



£00 OF THE SCARLET FEVER. 

There is also another variety of erysipelas, confined 
to the legs, called the rose. This is apt to become chro- 
nick, and therefore ought to be promptly treated. The 
best remedy for this disease, in its forming stage, is blis- 
tering over the part; bleeding moderately from the arm; 
cooling purges, and drinks, and a low diet. All spices, 
spirits, and animal food, must be avoided in an erysi- 
pelas. 

Should the rose become established, all the usual re- 
medies for strengthening the constitution must be resort- 
ed to; the part affected should be frequently bathed with 
a strong decoction of oak bark; or cold vinegar and spi- 
rits of some kind: and an issue put into the arm. These 
remedies, with temperate habits, will often remove this 
troublesome disease. 

SECTION XVI. 

Of the Scarlet Fever. 

This fever comes on in the usual way, with chills and 
heat: nausea; headach; pains in the back, &c. The 
skin is soon covered with a deep red eruption; in blotch- 
es sometimes, at other times all over the body. These 
detach the scarfskin, and it falls off in thin seales in 
three or four days. A genuine scarlet fever is a mild 
disease, and requires nothing but rest; strict low diet; 
the mildest tepid drinks; a little cooling physick; and in 
severe cases, abstracting a little blood will be necessary. 

There, however, are low or malignant fevers, accompa- 
nied with the appearances of scarlet fever. These are 
generally referrible to malignant sore throat; or what has 
been called spotted fevers. This grade of fever requires 
an opposite treatment, to that above laid down for com- 
mon scarlet fever. And it will be necessary to turn to 
the remarks which are to be found in this work, on ma- 
lignant fevers. 

This low grade of scarlet fever, however, should be 
treated first with an emetick, of ipecacuanha, or antimo- 
nial wine; then the bark, conjoined with snakeroot, or 
camphor, and the mineral acids well diluted: coffee, 



OF THE CHICKENPOX. 201 

bitter teas, cool; and sometimes wine whey should 
be given; broth may be allowed, and ripe fruits, &c. It 
is essential in every grade of this disease, to observe 
strict cleanliness; and to have the patient's room well 
ventilated; but sudden changes of temperature, are care- 
fully to be avoided. This disease puts on much of the 
appearance of an epidemick. 

SECTION XVII. 

Of the Chicken-pox. 

This disease affects persons but once in life, and it is 
mostly in infancy. It generally comes on with slight fe- 
brile symptoms; these are followed the second or third 
day, by pimples distinctly defined, and generally but 
few in number. In six or seven days, from the attack, 
the pustules are dried up and fall off, sometimes leaving 
pits, which never disappear. These pustules are always 
filled with limpid, or a whey-coloured fluid, which dis- 
tinguishes them from smallpox, which last are always 
filled with yellow pus. 

It was once a matter of the utmost importance to dis- 
tinguish between the chicken and the smallpox; but as 
we may now always have our children secured by vac- 
cination from the smallpox, it cannot be of so much im- 
portance, nor can we easily err. I have once seen this 
disease accompanied with high fever and delirium. 

The patient should be kept cool; take a little cooling 
physick, and live abstemiously, and by carefully avoid- 
ing heating drinks, or much animal food, the case soon 
terminates in health. 

SECTION XVIII. 

Of the Quinsey, or Inflammation of the Throat. 

This like all other local inflammation, is attended with 
more or less fever. But is principally known by pain 
in the throat with swelling. This swelling and an in- 
flammation is evident on looking into the upper part of 



202 OF THE CHICKENPOX. 

the throat; pain and difficulty in swallowing comes on; 
and soon renders it impossible to swallow solids. And 
when the disease runs high, breathing is painful, and 
difficult; and a total inability to swallow attends, so that 
if the patient suffers fluids to pass into his throat, a sense 
of suffocation is excited; and the drink is forced, with 
impetuosity through the nose. A constant repetition of 
the act of swallowing takes place; and troubles the pa- 
tion excessively. 

If the disease is well treated, it is seldom dangerous^ 
but fatal errours might arise from mistaking malignant 
sore throat for this mild disease. By attention to the 
prevailing diseases, and often from the patient's being 
subject to quinsey, we may distinguish this more simple 
disease from the malignant. This disease is generally 
excited by cold, dampness, &c. succeeding fatigue, or 
overheating. It is, however, often excited by breath- 
ing in a room very much crowded. If it is attacked ear- 
ly, suppuration may mostly be avoided. We should 
bleed once or twice; purge freely; enjoin strict absti- 
nence; the weakest tepid drinks should be used. A 
piece of flannel should be applied, and the outside of the 
throat frequently rubbed with volatile liniment. If the 
symptoms still advance, we must await suppuration; and, 
in general, it will only be necessary to keep quiet; the 
bowels open; and gargle the throat frequently with milk 
and water. If symptoms of suffocation threaten, we 
must bleed moderately, even during suppuration; and 
gargle frequently with a gargle of sage tea, containing 
vinegar and honey. A blister applied round the throat 
at an early stage of this disease, Avill be useful, by pre- 
venting suppuration. It sometimes will be necessary to 
keep up slight nausea, by the use of ipecacuanha, or an- 
timonial wine. 

If the suppuration is tardy, a poultice of onions should 
be applied. It will always be necessary to guard the 
neck well from cold; to avoid crowded rooms, and pre- 
serve the feet warm and dry, after a spell of quinsey. 
For, persons once severely affected with it, are liable to 
repeated attacks on getting cold, &c. 



W MUMPS, OR ANGINA PAROTIDJEA, &C. 203 

SECTION XIX. 

Of Mumps, or Angina Parotidcea. 

The mumps is a painful swelling of the parotid glands. 
It generally comes on with some fever; stiffness of the 
neck; then comes swellings behind the angles of the low- 
er jaw, and severe pain on moving the jaws; severe sting* 
ing sensations through the inflamed glands, especially on 
tasting any article not entirely insipid: the swelling be- 
comes so considerable as to affect swallowing, in many 
cases. ^In three or four days the swelling, mostly, be- 
gins to subside; and sometimes is suddenly translated to 
the scrotum in men, or mammm in women. 

This disease is generally mild, and unattended with 
danger; but sometimes the fever runs very high, and is 
attended with delirium, and pain of the testes, or of the 
mammce; and requires much care. This disease some- 
times appears in the character of an epidemick: and at- 
tacks but once in life. In most cases, it will only be ne- 
cessary to enjoin rest; and to avoid cold, or wet weather; 
to wear flannel round the neck; rub the swelling with the 
marrow of salted hog's jaws; or a little weak volatile 
liniment. But if the symptoms run high, we must bleed 
according to the urgency of the case. 

If the disease is translated from the neck as above- 
mentioned, apply a blister to the throat, of considerable 
size: and give a dose or two of cooling physick. No 
local application ought to be allowed, in any case, to the 
testes or mammae. The diet must be abstemious; and 
the drinks cooling. 

SECTION xx. 

Of the Miliary Fever. 

This is seldom a primary disease, but often a symp- 
tom of other fevers; partaking of every grade. Being 
sometimes highly inflammatory, and at others, of a ma- 
lignant cast. All the cases which I have seen, of this 



%04* OP MALIGNANT FEVER. 

fever, were in childbed women; and always proceeded 
from a too hot regimen, and close rooms, &c. There 
was an eruption of very small pimples, of a pretty bright 
red colour, attended with itching of the skin; and smart- 
ing of the eyes; high fever, with full quick pulse; chills 
and heat, blended, or alternating with each other; head- 
ach; and sometimes delirium; great thirst, and some diffi- 
culty of breathing: very generally accompanied with a 
retention of the usual discharges at this time. 

Bleed, according to circumstances; but in healthy wo- 
men at an early stage of the disease, we should bleed 
once pretty copiously. Open the bowels with cantor oil, 
rochelle salts, or senna and manna, with a few grains of 
soda; enjoin a cool regimen, with the mildest tepid, or 
rather cool drinks. Cremor tartar, and small doses of 
nitre, will be useful. 

In mild cases we may content ourselves with opening 
the bowels with cooling injections, which are always ne- 
cessary for childbed women, and a cool very low regi- 
men, and frequent changes of linen, and bed clothes, 
together with free ventilation by removing bed curtains, 
&c. taking care always to avoid a draught of cold air, 
immediately on the patient; as well as all heating articles 
of food, drink or medicine. Audit will be a good rule 
with such patients, if able, to dress and lie on the bed 
during the day. This treatment will apply to all per- 
sons affected with a miliary fever of a common inflam- 
matory grade. For the treatment in malignant fevers, 
taking on this kind of eruption on the skin, I must re- 
fer the reader to the various articles on malignant fe- 
vers, &c. 

SECTION XXI. 

Of Malignant Fever, arising from Local Causes. 

This fever has usually been considered a putrid fe- 
ver, but I have elsewhere said the term putrid should be 
banished from our medical nomenclature. This opinion 
is not mine, but was propagated by Dr. Rush, and others. 
We find it placed in Rush's theory of fever, at the head 



OF MALIGNANT FEVER. £05 

of his scale. It is there supposed to transcend the com- 
mon force of inflammatory action. I have, in a prece- 
ding article said, [See general observations on visceral 
inflammation] that the sudden fatal termination of those 
fevers, may be owing to inflammation passing by the ves- 
sels concerned in common inflammation, and attacking 
the brainular or sensorial system. 

This, however, does not change the case as respects its 
treatment, it is still neither a putrid fever, which is a 
thing impossible; nor a nervous disease, according to the 
commonly received notions of nervous diseases. Bat a 
disease of the highest grade, seated in an organ most es- 
sential to life; and it is only by reducing the circulating 
powers that we invite the disease from the nerves, to the 
blood vessels, or by more slow remedies, equalise the 
morbid excitement. This is always a difficult thing, for 
in a few hours, and sometimes even before disease is per- 
ceived, the blood vessels, and whole system is invaded 
by this nervous inflammation, and prostrated below a 
power of reaction. 

Malignant fever is generally known by sudden, and 
great prostration of strength; sick stomach, an absence of 
chills, and most generally of pain. A slow, depressed, or 
intermitting pulse takes place; and is soon followed by 
extreme anxiety and restlessness; disposition to faint, on' 
moving. Sometimes with diarrhoea, but oftener with tor- 
por of the bowels, and costiveness, vomiting, dulness and 
heaviness of the eyes, attended often with inflammation, 
soreness about the stomach, a disposition to sigh, tre- 
mours. The tongue is usually, as well as the teeth, co- 
vered with a black crust. To these symptoms, often suc- 
ceed eruptions on the skin, or in the mouth. The skin is 
sometimes preternaturally warm, at other times cold. 

This form of fever is found in jails, dirty hospitals; 
in smallpox, hydrophobia, from taking opium, and in 
yellow fever, &c. When it is not occasioned by an epi- 
demical atmosphere, which is often the case, it is strictly 
a fortuitous disease, having its origin from filthiness, un- 
wholesome diet, and exposure to great fatigue, night air, 
much wet, &c. If due regard is had to cleanliness, and 
high, open ; dry grounds, chosen for camps; and healthy 



£06 OF MALIGNANT FEVER. 

situations, spacious rooms, open yards, free ventilation, 
strictest possible cleanliness, frequent white washing, &c. 
in hospitals or jails, is observed, we should hear but lit- 
tle of malignant fever in those places. This fever may 
be excited in camps, &c. from using too much animal 
food; and more especially from wet straw, too long used^ 
together with neglect respecting privies, slaughtering 
places, and the usual offals. Where those things are not 
most rigidly attended to, and buried or burned, malig- 
nant fever or dysentery, will thin the ranks. 

In the cure of those fevers, we are to commence with 
free ventilation and attention to cleanliness, gentle eme- 
ticks of ipecacuanha and calomel; and, if called early, a 
little blood should be taken; and, if the pulse rise, or 
active pains come on, we must repeat the bleeding. The 
bowels should be freely opened with calomel, and this 
medicine continued, in small doses, two or three times a 
day. The mildest diaphoreticks should be given, as salt 
tartar, or soda, mixed with lemonade, or vinegar sugar 
and water, or weak punch, cremor tartar water, with a 
very little ipecacuanha in it, and the most perfect rest 
enjoined. 

If the patient seem to sink under this treatment, we 
should give ether; pretty generous punch, made of fruit, 
vinegar, or cremor tartar; push the calomel; blister over 
the stomach; apply sinapisms to the feet. Give cool cof- 
fee, or bitter infusions, for drink. If inflammation ap- 
pears in the mouth or throat, a mixture of soda, or salt 
tartar with honey and water, should be very often used 
as a gargle. And in very low r cases, an infusion of red 
pepper in water, should be used in the same way. The 
bark, or other stimulants, can seldom be safe, until the 
patient is convalescent, when the bark and acids may be 
given, but commenced in small doses, and gradually in- 
creased. I have generally seen good effects from the use 
of the camphor powders, which will be found by refer- 
ence to the list of medicines in this book. 



or TYPHUS FEVER. 307 



SECTION XXII. 

Of Typhus Fever, arising from Local Causes. 

This fever, like the malignant just spoken of, is often 
found in camps, jails, dirty hospitals, &c. It has gene- 
nerally got the name of nervous. As this is but a low 
grade, or chronick form of the disease, treated on in the 
preceding article, I shall refer the reader to that article, 
and proceed to describe the symptoms, and cure, of this 
lowest grade of fever. In general it arises from the same 
causes as the malignant fever, in camps, jails, &c. which 
operate less forcibly, and, therefore, more slowly. This 
less concentrated, but long continued cause, produces a 
set of symptoms less violent, but chronical; and, unless 
skilfully treated, equally mortal. 

The symptoms, commonly, are a weak frequent pulse, 
drowsiness, languor, tremours of the hands, a dry tongue. 
These symptoms are soon attended by low muttering, 
coma, delirium, diarrhoea, or torpor of the bowels, sub- 
sultus tendinum, deafness, black or dark tongue, tum- 
blings, picking about with the fingers, and constant efforts 
at collecting the irregular ideas which the patient is sen- 
sible of, but cannot collect. These all give way, some- 
times, to constant, heavy, uneasy sleep, from which the 
patient can only be roused by such violence as always 
seems to alarm him. The mouth is generally open du- 
ring sleep, which adds to the unpleasant dryness of the 
tongue, mouth, and throat; utterance is generally indis- 
tinct, and often lost. Even where the organs seem to 
possess the power, the mind is unable to arrange ideas, 
so as to enable the sufferer to complete even a short sen- 
tence. 

The treatment of this disease should be commenced 
with a gentle emetick of ipecacuanha or antimonial wine, 
if this does not open the bowels, injections slightly pur- 
gative, should be given. Calomel, in doses of from three 
to five grains, should be given: and, if the mouth is not 
affected in three or four days, the dose should be increa- 
sed rapidly, until thirty grains, or even more, are given 



OP TYPHUS FEVER. 

per day: taking care always to provide the patient 
with opium; or laudanum, which must be taken in such 
quantities as will restrain the calomel, from acting on the 
bowels. 

If this course does not soon affect the gums, the use of 
mercurial ointment should be joined, with that of the ca- 
lomel, and rubbed freely into the thighs, and worn on the 
feet in socks or stockings. During the use of the calo- 
mel, the patient should take wine in reasonable quantity, 
and snakeroot, or valerian tea. This treatment will 
sometimes raise inflammatory symptoms, fever, full pulse, 
pains in some part of the body, thirst, &c. If this should 
happen, the patient must be bled moderately, and even 
repeated if the symptoms indicate it. But even here, we 
must not cease to press on the calomel, infusions of snake- 
root, &c. but wine and opium should be withheld; al- 
ways, however, recollecting, it is better to give opium 
than to quit the calomel, or letting the patient sink under 
a purging. So soon as the disease seems completely set- 
tled into a typhus, blisters should be applied freely, and 
repeated as fast as they heal. The bark must be began 
with, and used along with the calomel, if the case conti- 
nues many days. In short, the principal remedies in this 
disease, are wine, tonicks, blisters, and mild diaphoret- 
icks, but, more especially, calomel, to any extent which 
may be necessary, to affect the gums. For the frequent 
low spells which such patients are subject to, called by 
country people, the patient of death, pretty large doses 
of ether, or spirits hartshorn, will be proper. In very 
low cases, even raw brandy should be given, in large 
quantity. I have given a pint of wine, and a pint of raw 
strong French brandy, to patients low in this disease, 
every twenty-four hours; so soon as the disease seems to 
be subdued, a nourishing, but thin light diet should be 
used, with bark and wine. 

I cannot close this article without a declaration, as im- 
portant as it is true. I have seen many cases of this dis- 
ease; I never saw one recover from the use of stimulants, 
without mercury. I have treated many in the way above 
laid down: I have never lost a patient. If I had seen 
but a case or two, I might admit this was accidental; bur. 



OF A SIMPLE INFLAMMATORY FEVER. £09 

I have seen and treated more than twenty cases, and I 
therefore beg leave to admonish every reader, that there 
is no safety in any course of treatment without mercu- 
ry: but when properly treated, it is seldom mortal, should 
it even become protracted. It may be necessary to cau- 
tion the reader, that few of our fevers remain stationary, 
for any considerable time. They are liable to change 
and become blended: typhus, sometimes, become inflam- 
matory, and vice versa, so do fevers often hold a grade, 
between those two extremes, called typhoid, &c. 

SECTION XXIII. 

Of a Simple Inflammatory Fever. 

This is also sometimes called a continual fever. It 
is rarely met with distinct from local inflammation. It 
generally succeeds wounds, burns, &c. and accompanies 
smallpox, quinsey, and many other inflammatory dis- 
eases. It, however, is sometimes met with as a primary 
disease, and may arise from exposure to changeable 
weather; heating diet, or drinks; or any other causes 
which may excite pleurisy, &c. 

It attacks suddenly with chills, more or less severe, as 
the cause has acted with a greater or less force. There 
are pains in the bones, joints, head, sides or breast, the 
pulse full mostly, always tense and frequent; great heat, 
thirst, with considerable debility, and dry skin. Where 
the disease is violent, delirium, and difficult respiration 
attend. 

In this disease we must bleed, and repeat according 
to circumstances. Give cooling purges once a day, and 
accompany them with small doses of ipecacuanha, or 
antimonial wine, so as to keep up a slight nausea: after 
the bowels have been well evacuated, the pulse and 
pains reduced, we may in general, trust to small doses 
of nitre and ipecacuanha, with very free dilution, with 
the most cooling drinks, as cremor tartar whey, toast 
and water, slippery elm water, apple water, tamarind 
water, &c. Almost a total abstinence is necessary till 
the force of the disease is checked, Toasted bread 
%7 



210 OF THE DROPSY. 

soaked in water, roasted apples; bread with very weak 
tea, or a few spoonfuls of panada, without wine or spi- 
rits, will afford a sufficient diet: and even when the dis- 
ease is somewhat arrested, we must return to a full diet 
cautiously and gradually. 

A fever of this kind long continued, is a frequent 
cause of dropsy, and therefore should be promptly treat- 
ed; nor is it without danger, without the utmost care; 
free ventilation and cleanliness are essential: and as 
you value life, avoid animal food, even broth, and also 
all stimulant, or heating articles of drink, &c. Hard 
drinkers have always more or less of this kind of fever 
about them, which often terminates in dropsy, and very 
probably sometimes in the head, when it is not suspect- 
ed; and producing apoplexy, causes sudden death: or 
madness, or convulsions, which so often destroy drunk- 
ards. 

section xxiv. 

Of the Dropsy. 

This disease is certainly less common in the United 
States than some years back, owing, I suspect, to a more 
prompt and successful treatment of acute, or febrile dis- 
eases. For although a dropsy may arise from intemper- 
ance, too low watery diet, want of exercise, kc. in nine 
cases of ten, I believe, it has been occasioned by conges- 
tions, which follow visceral or other inflammation, impro- 
perly treated. 

By a more free use of the lancet, cool regimen, and 
the universal custom of free purging in febrile affections, 
few chronick diseases follow them; and more especially 
dropsy, and hystericks, seem to have lessened. Con- 
sumption, gout, and scrofula, are now the most leading 
maladies, arising from acute disease. I feel it my duty 
in making this declaration, which I am sure comports 
with my observations for many years, to add, that the 
medical faculty share no part of the blame, in giving 
this new direction to our diseases. The fault lies whol- 
ly in the people, who by enervating habits, carry about a 
chronick debility, which occasions those new disorders: 
and for which there is no remedy in the Materia Medi- 



OF THE DROPSY. 211 

ca. But industry, temperance, &c. are remedies which 
would drive chronick diseases in good measure, from 
our country. 

Dropsy has been distinguished by different names, 
according to the part affected by it. A general dropsy 
is called an anasarca; that confined to the belly, ascites; 
hydrops pectoris in the breast; and hydrocephalus, when 
situated in the brain: and although a dropsy generally 
speaking, is to be treated on general principles, it is of- 
ten necessary to vary the treatment, according to the part 
affected. I therefore shall first hint at a few peculiari- 
ties; and then speak of dropsy in general. • 

An anasarca is very generally an inflammatory dis- 
ease: and may be connected with ascites; or encysted 
dropsy of the ovaria, &c. In this kind of dropsy, after 
it is fully established, the patient should be rubbed 
twice a day briskly, with a flesh brush, or dry hand: 
the legs and abdomen should be moderately bound up, 
by applying rollers suited to the season, but in general 
very fine flannel is best; the bandaging must be began at 
the toes, and carried up over the abdomen; care must be 
taken, however, not to make it too tight. Such rollers 
are made by tearing the cloth into strips about three or 
four fingers width, and sewing them together at the ends, 
so as to leave no seams. The feet and legs may be sca- 
rified now and then through the skin, bv this much wa- 
ter will be discharged, and we are assured by Dr. Rush, 
no danger attends this practice. 

In an ascites the abdomen may be bandaged; and if 
the disease is much advanced, tapping will be neces- 
sary. In the dropsy of the breast tapping may also be 
performed, but only by an able practitioner. Less be- 
nefit can be obtained in this species of dropsy, than 
others, from purging; it is generally inflammatory, and 
requires the pretty free use of the lancet. If ever digi- 
talis is useful in dropsy, it is most allowable in this, af- 
ter suitable bleeding, and after depletion, we must rest 
the cure on the use of mercury, not omitting, however, in 
all cases, to keep the bowels open. 

In dropsy of the brain there is little to hope for, after 
it is formed, a salivation should be tried. This kind of 



SIS OF THE DROPSY. 

dropsy in most cases, proceeds from inflammatory affec- 
tions of the head, which are either overlooked, or mis- 
treated. I shall therefore point out, here, the premoni- 
tory symptoms of this fatal disease. 

Hydrocephalus most commonly affects children, but 
adults are also subject to it. . Symptoms — Languor, 
drowsiness, peevishness. The appetite weak, sick sto- 
mach, or vomiting once or oftener a day; the skin gene- 
rally hot and dry, especially towards evening: then 
sharp headach, often in the fore part, sometimes in one 
side; inclination to hold the head to one side, as though 
the neck was weak; pains in the neck, shoulders, extre- 
mities, and sometimes in the bowels. The patient dis- 
likes the light, cries much, sleeps little, which is disturb- 
ed; grinds his teeth, and starts or screams out frequently 
when dozing: bowels generally obstinately costive, 
sometimes in an opposite state; the pupils of the eyes 
become larger, the eyes look dull; violent delirium comes 
on, accompanied with fever. After these symptoms 
have continued, sometimes for a few days, in other mil- 
der cases for weeks, or even months, the pupils become 
more dilated; the patient less sensible of pain; a squint- 
ing; heavy slumbers, or perpetual restlessness: the pa- 
tient lies with one or both eyes opeu, which are often 
found insensible to light: convulsions often attend every 
stage of this disease. If food is presented, it is swal- 
lowed with voracity: the costiveness is now generally 
more obstinate. 

If this disease is discovered at an early stage, copi- 
ous and repeated bleed'ngs, and the free use of calomel, 
given until it operates freely on the bowels, and also af- 
fects the mouth, will seldom fail to arrest it. If the case 
has progressed some time, a salivation should be kept 
up. It will be obvious that low diet, weak cool drinks, 
rest and quietness, must be enjoined; and laying with 
the head high, must not be dispensed with; and if the 
patient is able to go about, the hot sun must be avoided, 
as well as much dampness. 

Hydrocele, or dropsy of the scrotum, requires also a 
particular treatment, which can only be safely conduct- 
ed by a skilful practitioner. Some relief may, however, 



OF THE DROPSY. £13 

often be obtained from a bandage in form of a cup, to 
contain the part, and tied up with strings to a handker- 
chief, or other bandage, about the body; by taking mo- 
derate doses of aloes and calomel daily, for some time, 
and by scarifications on the part: but a radical cure is 
only to be expected from an operation by seton, or in- 
jections. 

I come now to speak of dropsy in general. This, 
like all other diseased action, to which the human body 
is subject, is of a twofold nature; being sometimes in- 
flammatory; and at other times dependant on general de- 
bility: it is, however, highly probable, that all dropsies, 
or rather the diseases which precede them, are inflamma- 
tory. This inflammatory diathesis may be either gene- 
ral or partial. When a dropsy is really formed, we are 
still to examine the pnlse, the patient's constitution, ha- 
bits, the probable canse of the disease, &c. before we 
can safely attempt a cure. 

If the case is found inflammatory, we must bleed ac- 
cording to circumstances; give active purges, as calo- 
mel and aloes, or jalap, calomel and gamboge, daily; 
nitre and cremor tartar should be drank freely, diluted 
with a great deal of water: of these drinks the patient 
should drink largely; or cider, or tamarind water, with 
a very little soda, may be used with freedom. Should 
this course not succeed in two, three, or four weeks at 
furthest, according to circumstances, we must change the 
treatment, and treat it as a dropsy arising from debility. 

Here we find a continuance of a distressing thirst, but 
without fever; the other symptoms being nearly alike 
in tonick or atonick states of dropsy, I shall here give 
the symptoms which usually attend. A feverishness, 
great thirst, little urine, costiveness, the breathing be- 
comes tlifficult, the skin dry, heaviness or weariness, 
and most commonly more or less cough. In an anasarca 
a swelling of the feet is often the first symptom discover- 
ed, which rising upwards gradually, invades the whole 
body: even here, in most cases, those swellings have 
been preceded by some fever: swelling of the abdomen, 
added to the above symptoms, characterize the ascites: 
it is always necessary to sound the belly, lest we mis- 



314 OP THE DKOPSY. 

take a tympanites for water: if we hold one hand ou 
one side of the belly, or hold the ear near to it, and 
strike the other side of the belly gently, we may dis- 
cover a splashing-like motion of fluid v itlun. If it be 
wind, as in a tympanites, no such motion will be heard. 

In hydrops pectoris to these general symptoms, there 
is usually added an alarming sense of suffocation, if at- 
tempts are made to lie down; and when the disease has 
advanced, this is wholly impossible: the pulse is gene- 
rally tense, and hurried; and, even here, a skilful person 
can distinguish a fluctuation of water, on striking the side 
pretty smartly with one hand, while the other is applied 
to the opposite side. This affection of the chest may be 
known from an asthma, by its being constant; while the 
asthma intermits; from vomica, or suppuration, by there 
being less pain, cough, and fever generally in the drop- 
sy, while the difficulty of breathing is more distressing. 
High fever, however, often attends dropsy in the onset. 

After an inflammatory case of dropsy has been treated 
as above mentioned; or in cases accompanied with direct 
debility, which constitutes atonick dropsy, the treatment 
must be varied; and, in most cases, the following method 
will be proper. 

Let the patient avoid drink as much as possible; cool- 
ing fruits, or acid juice of fruit, taken gradually, must, 
as much as possible, supply the place of drink. The 
food should be dry, as hard biscuit, a little roasted meat, 
dry bread. &€.: animal food must be used very sparing- 
ly. The use of calomel, or the quicksilver pill, should 
3iow be advised; the blue ointment rubbed w r ell into the 
part affected in partial dropsy; and in anasarca into the 
thighs, and sides. The bowels must be evacuated with 
jalap and cremor tartar, &c. more or less freely, as the 
case partakes of inflammation. With these remedies the 
patient should use large quantities of horseradish; and 
take, now and then, a little nitre, soda, or salt tartar, in 
a little vinegar and water, lemon juice, or other mild ve- 
getable acid. 

Should the strength rapidly decline, we must support 
the patient with wine, biscuit soaked in brandy; whole 



Of THE DROPSY. %i5 

iii a start] seed, roasted fresh meat, or a little sound salted 
meat, or fish. 

Patients are found who increase in weight, more than 
the weight of the body and the food and drinks added 
together: this can only be accounted for on the supposi- 
tion that the body absorbs moisture, (amounting to fluids) 
from the air through the skin, or through the lungs; and 
most probably in both ways. So far as the skin is con- 
cerned, benefit may probably arise from rubbing the skin 
daily with nice oil; sweet oil, fresh lard, or butter well 
washed, or melted, will answer this purpose. 

Moreover, embrocations of oil have been found highly 
beneficial in fevers; and, on that consideration alone, 
they should be used in dropsy, if there is no other. 
Though nitre is a valuable medicine in dropsies, it must 
never be continued long, otherwise the stomach will suf- 
fer. It will always be advisable to wear flannel; and to 
leave off every thing like garters, tight waistbands, &c. 

In all dropsies, exercise is indispensable, and even la- 
bour has often effected cures. When the disease is re- 
moved, the bark, acids, cold bath, &c. should be used 
for some time, till the constitution is restored; and, even 
now, it will be advisable to take freely of horseradish, 
mustard, garlick, and now and then a little cremor tar- 
tar and nitre. Should a purging become too alarmingly 
great, in a low state of dropsy, a little good coffee may 
be taken; should this not succeed in checking it, injec- 
dons, containing a little laudanum should be given: and 
in extreme cases, apply a large blister over the belly: 
but these are things very seldom necessary. Through- 
out the whole course of both kinds of dropsy, exercise, 
frequent, and long continued rubbing, carrying the hand 
upwards, and moderate bandaging with flannel rollers 
applied, will be advisable; but, unless they are carefully 
applied, so as to be smooth, and equally tight in every 
part, it would be better to omit i]wm altogether*. 



£16 OF THE RHEUMATISM. 

SECTION XXV. 

Of the Rheumatism. 

The rheumatism commonly comes on like a common 
inflammatory fever, which is soon attended with severe 
pains in the limbs, or rather in the joints; these gener- 
ally seem enlarged. When the symptoms are in the 
most aggravated form, the joints are permanently distor- 
ted. I have seen cases where the hip joint was thrown 
out of place, by rheumatism. There is also cases, 
where, in young subjects, the first notice of the disease 
is a pain and swelling in one of the joints, as the knee, 
hip, &c. 

The treatment here, must be the same as that recom- 
mended for the inflammatory fever; to which must be 
added blisters, to the part: and of all articles, the best 
is the ointment of corrosive sublimate, reduced by mixing 
it with a little lard, so as to excite a blister, first on one 
side, and next day on the other; the joint should then be 
lapped in heated cabbage leaves. If this does not soon 
relieve the patient; after the system is reduced by one or 
more bleedings, according to circumstances, with the low 
diet, purging, &c. recommended in inflammatory fever: 
it will be advisable to put the patient on the following 
course. For an adult, take salts one ounce, calomel ten 
grains, tartar emetick two grains, make twelve powders, 
after grinding the salts fine. Give one of these morning 
and evening; and let the patient drink largely of milk 
whey, or elder blossom, or ground ivy tea. 

Duriug all this time, rub the part affected two or three 
times a day, with equal parts spirits wine saturated with 
camphor, and tincture tolu. If this cannot be had, very 
strong volatile liniment may be used, or an Infusion of 
red pepper, in whiskey. 

If the disease does still not yield completely, give a full 
dose of Dover's powder; let him go to bed, and refrain 
from drink for about two hours, then begin and drink 
freely of wine or milk whey; as the case may be more or 
less inflammatory, we must regulate the quantity of wine. 



OF THE APOPLEXY. 217 

This may be repeated, if necessary, for two or three 
nights. The patient is to remain within doors during 
this time, and when able to go out, must be carefully 
dressed; never omitting to have flannel next the skin. 

A return to the usual diet must be made with great 
caution, and always gradually. So soon as a convales- 
cence is well established, the cold bath should be used 
and constant exercise enjoined daring good weather. If 
the disease does not yield, or if the patient is subject to fre- 
quent relapses, especially without a swelling of the joints 
affected, we may conclude the disease has taken on the 
chronick form, and is now in some measure habitual. 
For the treatment of chronick rheumatism I must refer 
the reader to the class of habitual diseases. 



section xxvi. 

Of the Apoplexy. 

The immediate cause of an apoplexy is a rupture of a 
blood vessel in the head, or a very sudden accumulation 
of a watery fluid, which leaves the brain no time to ac« 
commodate itself to the stimulus, &c. arising from the 
pressure. It is supposed, persons of short necks, and 
florid countenance, are most subject to this disease. Its 
most usual remote or predisposing cause is intemperance 
of every kind. 

This disease is often preceded by giddiness, drowsi- 
ness, noise in the ears, night mare, &c. and sometimes 
loss of memory, but in general there is very little notice; 
persons sometimes fall down dead, or at once into dread- 
ful stupor; the breathing becomes laborious, and loud, 
like a person snoring, the face sometimes flushed, at oth- 
ers pale. In short, a person in an apoplexy, resembles 
in appearance one in a very heavy sleep, but from which 
the apoplectick cannot be awaked; the pulse is various- 
ly affected, being sometimes full, at others depressed and 
corded. 

In persons of full habits, we must bleed copiously: no 
disease, generally speaking, requires such copious bleed* 
ings, we must open a vein, and let it bleed until the pa- 



£18 OP THE PALSY. 

tient recovers his feeling, in some measure, or as far as 
is consistent with life. Dr. Rush tells us, that Dr. Phy- 
sick drew ninety ounces of blood from Dr. Dewees, at 
one bleeding, in this disease, and thereby, so completely 
relieved him that he was enabled to attend to his ordina- 
ry business in three days. It would also be proper to 
open the temporal artery and let it bleed freely. Stim- 
ulant common injections should be given, as a handful of 
salt, in the usual quantity of water, or a strong decoction 
of senna, &c. 

Purges should never be given till the vessels are emp- 
tied by bleeding, for, by exciting vomiting, they may do 
mischief. The head should be laid high, and free circu- 
lation of air kept up about the patient, on a hard bed. 
Cold applications should be made to the head. 

But the cure is principally to be trusted to copious, re- 
peated bleedings, and strong purging glysters. Many 
persons might be saved in apoplexies, by a bold and im- 
mediate use of the lancet, who are lost by waiting on a 
physician. The drink must be cool, and of the weakest 
kinds; and when food is desired, the lightest articles 
should be given for a few days even after recovery. 

SECTION XXVII. 

Of the Palsy. 

A palsy is so different from all other diseases that ii 
cannot well be mistaken. It has been named according 
to the part affected: hemiplegia, when one side of the 
body is affected. Paraplegia, when affecting the lower 
part of the body. Like most other diseases, palsy is 
sometimes accompanied with inflammatory symptoms, 
and sometimes with direct debility. It seldom affects the 
whole body. When the pulse is full and strong, or de- 
pressed, the face flushed, the breathing difficult, we must 
bleed freely, and repeat frequently; apply blisters to the 
head in hemiplegia, or over the limbs affected in para- 
plegia. Strong purging injections and purgatives should 
be given, and repeated often: the affected limb should 
be rubbed with flour of mustard. And as soon as the 



OF THE TETANUS, OR LOCKED JAW. 219 

febrile symptoms abate, or in cases depending on evident 
direct debility, we must pursue an opposite course of 
treatment: a cordial diet, of light nutritious articles, as 
light well boiled meats; or, a little salted meat, in warm 
weather in particular; eggs, coffee, broth, milk, &c. 
Cordial drinks, as wine and water, bitter infusions of 
pleasant herbs, chocolate, &c. with the free use of mus- 
tard, horseradish, ginger, &c. The most stimulant me- 
dicines, as volatile tincture, guaiacum, ether, valerian in 
powder, or in tea; whole mustard seed, electricity, &c. 
Nor must constant dry rubbing be omitted, aud now and 
then accompanied with the use of volatile liniments, or 
dry mustard powdered. 

Exercise must be enjoined as soon as it is practicable, 
and followed up with spirit, and constancy. Cheerful 
company is always useful. Compouud spirit of laven- 
der, is a good medicine: vomits are sometimes useful, but 
they must be very gentle, and are not often necessary; 
but where there is a troublesome nausea, or want of ap- 
petite of some standing, they should be tried. Benefit 
is sometimes derived from cephalick snuff, or sternutato- 
ries: forms for these will be found in the list of medi- 
cines. 

SECTION XXVIII. 

Of the Tetanus , or Locked Jaw. 

The tetanus has been variously named according to 
each particular set of muscles affected: but these distinc- 
tions are useless, for the cure must be conducted on ge- 
neral principles. Regard should, however, be had to its 
cause where it is evident. It generally arises from 
wounds, and most commonly from very trifling one?: a 
stroke with a whip, stumping the toe, tramping on a 
nail, &c. But sometimes it is occasioned by other dis- 
eases, as yellow fever; from pneumonia, and also from 
poisons, fear, &c. Where it arises from other diseases, 
the cure must principally consist of such remedies as are 
suitable for the diseases from which it arose: but I be- 



2S0 OF TftE TETANUS, OR LOCKED JAW. 

lieve the tincture of cantharides should always be givea 
freely, without regard to the cause of tetanus. 

Dr. Rush tells us, that " tetanus, from all its causes, 
has nearly the same premonitory symptoms. These are 
a stiffness in the neck, a disposition to bend forward, in 
order to relieve a pain in the back, costiveness, a pain 
about the external region of the stomach, and a dispo- 
sition to sleep. In this feeble state of the disease, an 
emetick, a strong dose of laudanum, the warm bath, or 
a few doses of bark, have often prevented its being com- 
pletely formed. When it has arisen from a wound, 
dilating it, if small or healed, and afterwards inflaming 
it, by applying to it turpentine, common salt, corrosive 
sublimate, or Spanish flies, have, in many hundred in- 
stances, been attended with the same salutary effects." 

If the disease advances, the pain about the stomach 
increases, the patient's head is violently bent towards 
his breast; or his head and heels are drawn backwards 
till they sometimes meet; or the jaws are immovably 
fixed together, so that almost no violence is sufficient to 
force them open. These symptoms intermit for a few 
minutes, but only to return with greater violence, and 
as they advance, approach the nature of convulsions. 

All the cases of tetanus which I have seen, were 
males. I have seen and checked the premonitory symp- 
toms mentioned by Dr. Rush, by applying hot turpen- 
tine to sores, as old burns, &c. I have also seen a case 
of tetanus succeed an inflammatory affection of the 
breasf, in a patient in the Baltimore hospital. This case 
was arrested, after it was formed in great force, by the 
usual remedies for pneumonia, and the free use of the 
tincture cantharides until a strangury was excited. 

Should a patient be affected with this disease, and no 
physician at hand, there should be a careful examina- 
tion of the body, and if any sores are found, or if it is 
knoAvn that within a few days, or even several weeks 
before, the person tramped on a sharp body, &c. the 
part should be irritated by applying hot spirits turpen- 
tine, or the strongest hot ley, or salt and water hot. 
And if the disease has not advanced far, or in other 
words, if it is but a few hours since the symptoms ap- 



OF THE TETANCS, OR LOCKED JAW. £81 

peared, a strong vomit should be given; for this purpose 
thirty grains of white vitriol may be given, and repeat- 
ed every ten minutes till it operates freely; or a large 
portion of antimonial wine given every fifteen minutes, 
till it operates freely: for children, the doses must be re- 
gulated according to the table for dosing medicine. In- 
jections containing large quantities of laudanum, and a 
little spirits of turpentine, as two tea spoonfuls of spirits 
turpentine; or to the laudanum may be added, five or ten 
drops oil of amber: these should be repeated every three 
or four hours, in glysters of the usual quantity of water. 
If the jaws are closed, an attempt must be made to open 
them with a spoon-handle, a smooth stick, or a piece of 
ivory. Sometimes one or more teeth being out, gives 
us an opportunity, without any further trouble, to give 
large quantities of wine, which should be commenced 
immediately; and at the same time opium, in doses of 
two, three, or even six grains should be given, and re- 
peated every three or four hours: oil of amber, in doses 
of from five to ten drops, should be given every two or 
three hours in wine; and in desperate cases, brandy 
should be given largely. The warm bath should be 
used, twice or more, every day, and continued as long 
as it can be borne at each time. 

If the cold bath is useful in this disease, it must be at 
an early stage; I suspect it is always a dangerous reme- 
dy. I have seen almost instant death succeed it in one 
case. It should never be used without good advice. I 
should place my principal dependance in all cases of te- 
tanus, on a very constant use of the warm bath, and the 
free use of tincture cantharides, as a tea spoonful every 
few hours; and the free use of wine, never forgetting, 
however, to apply^some powerful stimulant to the wound, 
if it should arise from that cause. 

Benefit is sometimes derived from dilating the wound 
with a knife; but, unless the part is very superficially 
situated, it must not be attempted but by the surgeon. 
Where it arises from an amputation, stimulants, the most 
powerful, must be applied to the stump, and the case 
treated on general principles. If it proceeds from low 
fevers, or if the case becomes protracted, large quantities 
of bark should be given. 



£22 OF THE ST. VITUS'S DANCE, 

SECTION XXIX. 

Of the St. Vitus' s Dance. 

This disorder is known by convulsive motions of one 
side: the leg is generally dragged after the patient, like 
that of a palsied leg: the arm is full of antick gestures, 
and in perpetual motion; so that when the patient at- 
tempts to carry any thing to the mouth, it is done with 
precipitancy. It sometimes becomes so violent as to 
convulse the whole body, and bears a strong resemblance 
to tetanus. It possibly may, sometimes, arise from an 
affection of the brain; but in a majority of cases it is 
brought on by falls, or injuries done some part of the 
body. It was excited in a brother of mine, by a fall on 
the ice. 

All the cases which I have seen were in patients un- 
der fourteen years, as remarked long since by the great 
Sydenham. I have always succeeded in curing the dis- 
ease in a few days: and although it has sometimes re- 
lapsed, from fatigue, &c. still the same treatment soon 
checked it, and the cure became permanent. 

Treatment. — Bleed moderately once; then give a 
purge; after this, put the patient on the use of valerian, 
and in severe cases, combine it with bark. After using 
this a few days, or, what will answer equally well, is a 
dram of iron filings, and a dram of assafcetida, made into 
twenty-four pills: of these, four may be used daily; 
drinking after them a little bitter infusion of some plea- 
sant root or herb. After using either of the above pre- 
scriptions a few days, the cold bath should be used daily, 
for some time. And, after the disease is removed, a lit- 
tle bark, or a few of the above pills, should be taken 
now and then, till the health is well re-established. 



OF THE HYDROPHOBICS FEVER. 323 

SECTION XXX. 

Of the Hydrophobick Fever. 

I purpose under this bead, first, to speak of the usual 
appearances of mad dogs; secondly, of the preventives; 
and, lastly, of the disease, when it breaks out in the 
dreadful form of the disease, usually called hydrophobia^ 
but which I shall designate by the name of hydrophobick 
fever. It has been supposed that unwholesome food, too 
much heat, and excessive thirst, was the usual cause of 
this disease in dosrs. But from the great number of wild 
animals which go mad, it is probable there is something 
in the constitution of the canine race in particular, and 
also in some other animals, which predisposes them to 
this disease, from some cause yet unknown; but, like 
causes which produce malignant fever, sometimes quite 
local, at other times diffused through considerable space. 
We have several instances in this country of wolves, 
foxes, and cats, going mad* and biting persons, some of 
which have went mad. 

In many instances of this fever in dogs, the first notice 
we have had of their indisposition is from abroad. So 
sudden is the attack, that a dog who has discovered no 
symptoms of illness at night, has been found running at 
a distance from home in the morning, with all the symp- 
toms of madness. In many cases, however, there is 
pretty strongly marked premonitory symptoms, which are 
these: he refuses food, looks dull, wishes to avoid other 
dogs, as well as the members of the family; be ceases to 
bark, seems timid, but snarlish, and ready to bite at 
strangers; his tail, ears, and whole appearance is droop- 
ed. His eyes become more watery: his tongue begins to 
hang out, and he froths at the mouth: in this situation, 
in general, he takes to flight, runs apparently heedless 
whither, and in his travels, goaded on by the most awful 
horrours, he bites every thing which he meets. 

There are instances, however, where a set of symp- 
toms very different accompany this disease: these are the 
same heavy watery eyes, loss of appetite, timidity, droop 



SM) OF THE HYDROPHOBICS FEVER. 

edness, frothing, &c; but instead of ill temper or taking 
to flight, he fondles, and caresses his master, and seems 
to beseech pity, and relief. In either case, the misera- 
ble animal is worn down by fever, borrows, and fatigue, 
in two, three or four days. 

There can be no doubt, but by far the greater number 
of dogs destroyed under a belief of their being mad, 
were either labouring under some other fever; or by fa- 
tigue, fear and fasting, owing sometimes to being lost 
they were bewildered: thus distressed, he is often pur- 
sued by persons and beat, stoned, and harassed in all 
quarters. No wonder he should take every one for his 
enemy, and attempt to bite: if he is a dog of spirit, he 
may now be said to be mad indeed, but in forty-nine ca- 
ses in fifty, perhaps, he has no hydrophobic]? fever, which 
certainly is a rare disease. 

Should a dog show symptoms of indisposition, he 
should be confined; and, has he bitten a person, or other 
animals, it becomes doubly necessary to confine him, and 
to spare his life, in order tbat we may judge with some 
precision, wb ether he was mad. The canine race are 
not the only animals liable to spontaneous hydrophobic]? 
fever: many cases are on record, of human subjects be- 
ing affected with it from excessive thirst, from yellow fe 
ver, putrid animal food, wounds from the bite of enraged 
animals not mad. It would seem to follow as a fair in- 
duction, that all animals liable to this disease from the 
bite of hydrophobick animals, are also subject to it from 
the usual exciting causes. 

I come now to speak of the preventives. Such has 
been the confidence reposed in various nostrums for this 
purpose, that I must avoid giving a positive opinion; I 
shall point out some of the most celebrated preventives, 
and detail some facts within my own knowledge. 

Dr. Richard Mead, whose reputation stood high as a 
physician, says, that the following had been used a thou- 
sand times, and never failed to prevent the disease. But 
subsequent trials have often disappointed the faculty. 
The prescription is this: "take ash-coloured ground liver- 
wort, cleaned, dried, and powdered, half an ounce; of 
black pepper powdered, a quarter of an ounce, mix these 



OF THE HYDROPHOBICS FEVER. 225 

together, and divide the powder into four doses; one of 
which must be taken every morning fasting, for four 
moruings successively, in half a pint of cows' milk 
warm. After these four doses are taken, the patient must 
go into the cold bath, or a cold spring or river, every 
morning fasting for a month; he must be dipped all over, 
but not stay in (with his head above water) longer than 
half a minute, if the water be very cold. After this ha 
must go in three times a week for a fortnight longer. 
The person must be bled before he begins to use the me- 
dicine." 

The following nostrum has been used with good faith: 
"take of native and factitiouscinnabar, of each twenty- 
four grains; take this at one dose, and repeat in thirty 
days; and if symptoms of the disease appear, take a dose 
immediately," this prescription is too ridiculous to re- 
quire notice. 

Another, "take purified nitre half an ounce, Virginian 
snakeroot in powder two drams, camphor one dram; rub 
them together in a mortar, and divide the whole into ten 
powders." 

The following remedy has been used much, in this 
country, and according to the late Rev. Mr. Muhlenberg, 
in Germany, and Switzerland also, for a considerable 
length of time. Take of red chickweed, or fanagal- 
lis phcenica,J which has been gathered when in full 
bloom, or ripe and dried in the shade: reduce it to pow- 
der, and give a small table spoonful, at one dose, to a 
grown person in beer or water, in weight one dram and 
one scruple; for a child an equal dose, but give it at three 
doses, or it may be eaten with bread and butter, or ho- 
ney, or molasses. For beasts, a large spoonful is a dose. 
This remedy, it is said, has succeeded several weeks 
after the bite of rabid dogs. The wound is to be wash- 
ed with the green juice. 

A majority, perhaps, of physicians, have given opin- 
ions in favour of mercury, as a remedy for this disease. 
There has beeu a ren.edy celebrated in some parts of this 
country, said to be the prescription of a Mr. Web; in 
this great stress is laid on nine leaves of sage. Jlmiil&te 
29 



226 OF THE HYDROPHOBICS FEVER. 

have also had their confidants, and have probably saved, 
as many as any of the foregoing remedies. 

I shall now conclude this part of my subject by stating 
the remedies used by myself, and also by my father: he 
commenced by having the part bitten well washed with 
salt water, then it was rubbed daily with mercurial oint- 
ment: at the same time Mead's remedy was given, and 
this succeeded by a course of mercury; after continuing 
this course a few days, it was omitted a few days, and 
the patient ordered to use the cold bath, as directed by 
Mead. In an extensive practice of upwards of forty 
years, not a solitary case of hydrophobia followed. 

When I entered into practice I felt so strongly prepos- 
sessed in favour of mercury, in this disease, that I ven- 
tured to change the treatment, and used nothing inter- 
nally but pills of calomel. I had the part well bathed 
with salt and water every day; and afterwards directed 
some strong mercurial ointment to be rubbed into it: af- 
ter leaving a day or two for the mercury to wear off, the 
patient was ordered to use the cold bath for some days. 
I have prescribed for at least ten, or twelve persons, who 
were bit by dogs really mad, they all escaped. 

Dr. Wilkin s of Baltimore, reposes great confidence in 
the use of caustick, to destroy the part. Dr. Mosely, 
well known in the medical world, recommends a similar 
practice. We are told by Dr. Zinke, at Jena, that the 
disease has sometimes made its appearance after the use 
of the caustick, and even where the part had been imme- 
diately cut out. 

A Dr. Stoey, in Pennsylvania, was long celebrated 
for the cure of the bite of rabid animals; after his death a 
patent was obtained by his family; I was solicited to take 
an agency in it: being very anxious to get information on 
this dark subject, I took an oath that I would not divulge 
the secret for fourteen years: I am not yet at liberty, but 
I feel it my duty to observe that the discovery made to 
me, was disgraceful to Dr. Stoey; nor was there any 
thing new in it. I therefore never acted, to give it a trial. 

Now we are well assured from various sources, that 
hydrophobia has followed the use of every remedy which 
1 have mentioned; even mercury which gained credit in 



OF THE HYDROPHOBICS FEVER. 227 

my own practice, and more especially in that of my fa- 
ther; has often failed according to Dr. Rush, and others. 
Mead's remedy, which had answered a thousand times, 
has, since failed, and I have knowledge of the chickweed 
failing also. In short, every method which ever has been 
practised has failed. 

In our present knowledge of this disease, we ought cer- 
tainly to try preventives, and I think none more rational 
has been offered, than to cut out the part when it can be 
safely clone, or destroy the neighbouring parts reasona- 
bly around, by means of caustick: and I should prefer 
arsenick for this purpose; we know it may be applied 
outwardly with safety; and the alkaline caustick, as 
well as the lunar caustick, have both failed to secure the 
patient. 

Give the chickweed or Mead's remedy; then touch the 
mouth a few days with mercury, let this wear off a little, 
and then use the cold bath, if it agrees with the patient's 
health, if not, tepid baths with a little salt; let this be 
continued for a few weeks. 

But, reader! startle not if I boldly pronounce, that you 
are in no more danger from the bite of a rabid animal 
than from the bite of a healthy one. I do not wish to 
prevent persons from using the usual remedies, but I feel 
it my duty to state as my confirmed opinion, that we 
wrong the poor dog; and what is worse, torment our- 
selves with notions for which there is no foundation. 

I now proceed to give my reasons for thinking the 
hydrophobick dog has no poison. 

1. Because the flesh of hogs that were labouring under 
this disease, has been eaten with impunity. 

2. The milk of cows affected with this disease has been 
used by whole families. 

3. Hydrophobia has been brought on by many other 
causes than bites. 

4. A number of rabid wild animals have been found 
nearly about the same time. 

5. Several dogs are generally found mad in the same 
neighbourhood, before the disease could have passed 
from one animal to the other. An intelligent old lady of 
Adams county assured me, that a great many dogs, and 



228 OF THE HYDROPHOBICS FEVER. 

other animals went mad prior to a very mortal low fever, 
which prevailed in the winter. It is also a fact, that 
many mad foxes and dogs were seen about the year 1810, 
just prior to a mortal fever which has prevailed there for 
several years. 

6. Dr. Rush tells us a case of hydrophobia followed 
an injury from a mad dog where the skin was not broken. 

7. Because no well marked cases are on record, or at 
least within my reach, of the disease following the bite 
very speedily; on the contrary, weeks and months; and, 
credulity says, several years have passed between the 
bite and the hydrophobick fever. 

8. Because, small wounds and other causes which 
produce tetanus, produce the same set of symptoms on 
whatever part of the body they were made. 

In short, I feel the fullest conviction that we have been 
all mistaken in our views of this disease; and as I have 
new ideas on the subject, I beg leave now to state them, 
hoping the reader will carefully attend to all I have said, 
as to its causes, &c. 

I believe, that hydrophobick fever arises from some 
unknown cause, but something like those which produce 
malignant fever, and that this cause is something like an 
endemick. I shall explain my views here by a few ca- 
ses. I prescribed for Alexander Ogle, esq. of Somer- 
set county, Pennsylvania, for a case of dog bite, which 
was attended with the following circumstances: this dog 
had been bitten by another: and a horse in Mr. Ogle's sta- 
ble was bitten by his own dog, about the same time he bit 
his master; this horse went mad and died, as I was in- 
formed, at Shippensburgh. 

Now is it not extremely probable, that this other dog 
which was in the habit of playing about the same yard 
and stable, as well as the horse being subjected to the 
same air, that they may all have taken this disease from 
the same source: if it arose spontaneously in one case, 
why not in all, the biting having probably nothing to do 
with either case. 

Dr. Rush gives the case of Mr. Todd's son, of Phi- 
ladelphia. In this case, the bite was on the sixth of Au- 
gust, and the symptoms made their appearance on the 



OF THE HYDROPHOBICS FEVER. 229 

13th of September, a period of thirty^eight days; the 
same dog bit a cow, a pig, a dog, and a servant. The 
cow and pig went mad and died; the dog became mad 
and was killed by his master. Now, is it not extremely 
probable, that this child, the two dogs, the cow, and the 
pig, were all exposed to the same cause. Why are we 
to suppose that it arose spontaneously in one dog, and 
accidentally in all the other cases? This is certainly de- 
serting the common rules of reasoning, and appears to 
me to have its origin in this. Of all animals, the dog 
seems most subject to this dreadful fever, his propensi- 
ties when enraged naturallv lead him to bite. If it is 
answered, that man, too, is prone to bite when affected 
with hydrophobia, I retort, that persons mad from other 
causes, as well as hysterical patients, will often bite the 
by-standers; and after all, this propensity to bite, is not 
so great as some people imagine. I shall presently de- 
tail a case which I have seen; to this we may add, the 
circumstance, that in most cases of this disease, the mind 
is prepossessed with a notion of this mark of the disease, 
and, I believe, cases are not wanting, where the imagi- 
nation has excited this disease, and led particularly to 
this symptom. 

Upon the whole, I take the hydrophobia to be a most 
malignant fever, as suggested by Dr. Rush; and I think 
it but a variety of tetanus. We know that tetanus arises 
from the same causes, and that the symptom of dreading 
water, is not universal in hydrophobick fever. This va- 
riety of tetanus (if I dare so call it) is principally seated 
about the throat, while the common form invades a cer- 
tain set of muscles; but both are alike attended with vio- 
lent disease of the whole system. 

I view the hydrophobia as partaking more of the com- 
mon inflammatory diathesis than tetanus. This is per- 
haps not the proper place to discuss this subject, I there- 
fore proceed to give what I think the most likely treat- 
ment for the disease when formed. The patient should 
be bled copiously, and the tincture cantharides given 
largely, as in tetanus, and the patient kept in a warm bath 
as long as it can be borne; mercurial ointment should be 
rubbed into the whole body, and particularly into the 



£30 OP THE HYDROPHOBICS FEVER. 

throat. This disease is extremely rapid, and passes 
sometimes through its inflammatory symptoms in a few 
hours; therefore, we should place our whole dependance 
in one or two bleedings, as large as are consistent with 
life; and the constant use of the bath as long as it can be 
borne at each time. We must now carefully watch our 
patient, and as soon as the symptoms yield, tonicks should 
be given, particularly the acids, freely; and the most pow- 
erful vegetable tonicks, as bark, in large quantity; or 
some bitter sudorificks, as valerian, snakeroot, &c. 

I have not had an opportunity of trying the above 
treatment; but, from the almost universal failure of other 
remedies, together with a full persuasion that it is but a 
variety of tetanus, 1 recommend the above with conside- 
rable confidence. 

I have still to relate one case of this disease, which I 
have seen. A German, near Chambersburgh, was bitten 
by a mad dog (and if a dog went mad spontaneously, why 
not the man too, when we know to a certainty it has ori- 
ginated in that way?) About five or six weeks there- 
after, when going to his sawmill, as usual, he felt a sud- 
den horrour in attempting to cross the millrace; several 
attempts were made; but he was obliged to return to his 
house. This poor man probably had but little dread on 
his mind; for, after being bitten, he had applied to a Ger- 
man minister at Chambersburgh, who gave him som& 
kind of an amulet, and dismissed him with full assu- 
rance that it would save him. [This great doctor is sinca 
dead.] 

He was now brought, in a wagon, to my father's: I 
was a lad at the time, and therefore cannot give the par- 
ticulars of the treatment adopted: nor have I access, at 
this time, to my father's minutes of the case; but the ap- 
pearance and actions of the patient made a strong impres- 
sion on my mind. He was perfectly rational the greater 
part of the time; all of a sudden he would signify that 
the paroxysm was coming, and in the same breath he was 
raging: he did make some slight efforts to bite, but the 
prevailing symptoms were a kind of desperate struggling, 
partly as though he was trying to escape, and partly 
struggling for breath. He was held down by four stout 



OF THE HYDROPHOBICS FEVER. 281 

men, always present; after he was completely exhausted, 
he seemed to swoon, and to lie feeble and calm; the 
breathing became easier, and he gradually recovered his 
mind and strength, so as to converse rationally with his 
friends for a considerable time. 

He expressed great horrour at the sight of water, and 
also at red and white clothes, ^te lived three or four days, 
the last of which his disease was completely subdued, 
and he was enabled to drink some water, through a tube, 
from a covered cup, and also to swallow a good deal of 
bread, rolled up in the form of pills: the first efforts at 
swallowing were painful and difficult. His friends and 
his physician had now considered him out of danger; all 
his friends had left the room, and were at supper; he was 
sleeping as sweetly and comfortably as a person in health: 
and had discovered no derangement of ideas that day. 
Apparently in his sleep, his eyes and eyelids began to 
tremble; a tremour or slight spasm ran over his whole 
body; he gasped two or three times, and his soul took its 
flight. Before his friends could assemble, he was no 
more; but it having fallen to my lot, with some other 
young members of the family, to watch during supper, 
the circumstances are still strongly impressed on my 
mind. 

I have thought this case worth relating for two reasons; 
the case was checked; and it is probable, had his phy- 
sician been aware of the great prostration of strength pre- 
sent, by a suitable use of tonicks he might possibly have 
saved the patient; for he, to all appearance, died from 
mere debility: let it not be thought that I throw a shade 
of blame on the humane physician who attended him; 
he had done much for him; but the case was rare, and no 
precedent for his guide. The other reason is this: Dr. 
Physick has proposed, and Dr. Rush recommends the 
measure, to open the windpipe, in order to let the patient 
breathe, till suitable remedies could be administered; but 
in this case no advantage would have been gained; and 
I am disposed to think this enlightened man, for once, 
is mistaken in his views of this disease. 

Should it then turn out, after sufficient observation, 
that this is a malignant statf* of fever, and originating 



238 OF THE HYDROPHOBICS FEVER. 

from other causes than biting by rabid animals; that this 
cause predisposes no more to it than any other small 
wound, allowance being made for the influence of imagi- 
nation; what a mass of anxiety, &c. may be saved! And 
if then, we can place this on the footing of other dis- 
eases, as tetanus, which arises, generally, from small 
wounds, humanity may still weep over the evils arising 
from our mistaken views, while ignorance, in the garb of 
murder, shall tremble at the horrid tales of persons ha- 
ving been bled, or smothered to death, because they were 
sick! 

I am aware that Dr. Zinke has related a set of ex- 
periments where he succeeded in producing hydrophobick 
fever, hy inoculating animals with the saliva of a dog, 
which had died of this disease. But how often have we 
been deceived hy experiments? Persons have in like 
manner been engaged in inoculating for the measles; 
they could sometimes succeed if the disease was preva- 
lent in the neighbourhood, but not otherwise; one could 
succeed with the blood, another by rubbing with a piece 
of flannel which had been worn; others again with the 
tears, while all these have been most generally ineffec- 
tual; and no doubt was only succeeded by measles when 
the patient was exposed to an atmosphere, or other 
causes, which give rise to measles. So with Dr. Zinke's 
experiments; he may have been misled by all the ani- 
mals having been exposed to the same cause which pro- 
duced this fever in his dog; and if liable to it accidently. 
why uot spontaneously? Or, after all, harsh treatment, 
and taking animals out of their usual habits, may pro- 
duce disease, and the imagination is ready to take up 
any indisposition for that which we wish to see.* 

* We are told by Culien, that carditis or inflammation of the 
heart, has been the cause ol \ hydrophobia. This is respectfully sub- 
mitted to the attention of the Faculty. Should it turn out, by dis- 
section, &c. that iiydrophobia always proceeds from inflammation 
of the heart, which I think highly probable, some correct or settled 
plan of treatment might be derived from a knowledge of the real 
seat of the disease. If it be an inflammation of this most impor- 
tant organ, we might possibly recommend blistering over the whole 
thorax, and be governed in the use of the lancet, by the same rules 
which govern us in cases of malignant fever, with local inflamma- 



OF THE SCURVY. £33 

The foregoing observations on hydrophobia have given 
rise to some clamour, and also to some very reasonable 
criticism; but, after the most mature reflection, I have 
thought proper to continue the article without alteration. 

The opinion maintained here, respecting the origin 
of this disease is not mine, it has been held by others 
long ago. But whatever may be the fate of this opinion, I 
have no hesitation in saying many things which were as 
contrary to settled opinions as this, have sometimes burst 
through the clouds of dogmatism and swept pyramids of 
errour from their foundation. To conclude, every liberal 
minded reader will perceive that I have faithfully given 
the usual remedies with all care, and have been so far from 
a wish of perversion that I have acknowledged some per- 
sons went mad who were bit by mad foxes, &c. but 
not, as I suppose, from specifick poison. Surely, then, 
my expression of doubts, in the almost universally re- 
ceived opinions, on this subject, will not subject me to 
illiberal criticism; for, he who follows my advice will 
carefully use means, while he cherishes a fond hope that 
he is in little danger: where the advantage of torment- 
ing his mind even if I am mistaken? And it will be per- 
ceived that I have written principally with a view of 
exciting inquiry which can do this subject no injury. 

SECTION XXXI. 

Of the Scurvy. 

The scurvy is thus correctly described by Sydenham: 
Ci It is accompanied with spontaneous lassitude; heavi- 
ness; difficulty of breathing, especially after exercise; 
rottenness of the gums; fetid breath; frequent bleedings 
at the nose; difficulty of walking; a swelling sometimes, 
and sometimes a wasting of the legs, on which spots al- 
ways appear, that are either lived, or of a lead, yellow, 
or purple colour, and a sallow complexion." 

tion from other causes. From the happy effects which the tincture 
cantharides has sometimes had upon tetanus, and from the probable 
similarity of tetanus and hydrophobia, with my present views I 
would blister the whole thorax. 
30 



234 > OF THE JAUNDICE. 

I have never seen a well marked case of scurvy in 
country practice. I have seen what is called land scurvy; 
this is an affection of the mouth and teeth, and is a habi- 
tual disease, and therefore will be found described in 
that class of diseases. Symptoms strongly resembling 
scurvy are often seen in chlorosis, which will be noticed 
in place. Scurvy is the sailors' scourge, but happily for 
mankind, such people have it in their power to banish 
this disease from the ocean, by taking a sufficiency of 
vegetables, as sourkrout, and other pickled articles; by 
having a supply of wholesome water, aud by strict at- 
tention to cleanliness, and exercise. 

In recent scurvy, provided the patient has access to 
vegetables, plenty of vinegar, or even mineral acids; he 
should be bled moderately, and take a little cooling 
physick, after which the cure may be trusted to the free 
use of vegetable food: all kinds of sallads, as also scur- 
vy grass, horseradish, and fruits, as lemons, oranges, or 
sour apples, or jellies of sour fruit, and in low cases the 
free use of generous punch; and this may be made in 
case of necessity, from vinegar, cremor tartar, or even 
vitriolick acid, or the nitrick, or muriatick acids. In 
cases of long standing we must not bleed, but rest the 
cure principally on generous punch, with a little fresh 
animal food, or good wine, in form of whey. The 
nitrick acid should always be used in this disease, for 
it is a powerful tonick, as well as a corrector of scorbu- 
tick action. 

section xxxn. 
Of the Jaundice. 

A common jaundice is discovered, first, by a yellow- 
ness of the eyes; the skin becomes yellow, aud the pa- 
tient often sees things with a yellowish shade over them; 
it is attended with itching, heaviness, lassitude, bitter 
taste; whitish excrements, or thin bilious stools, urine 
yellow, and stains linen a saffron colour; hiccup, and a 
bilious vomiting sometimes attend. If the disease be- 
comes obstinate, the eyes and skin put on a darkish yel % 



OF THE JAUNDICE. 235 

low colour, and the disease is now called the black jaun- 
dice. 

This disease is supposed to be occasioned by obstruc- 
tions in the gall ducts of the liver; by concretions, or lit- 
tle stone-like bodies, which are often found in the liver: 
it may, however, arise from torpor, or slight inflamma- 
tion of the liver, or from a secretion of unhealthy bile. 
I suspect gall stones are its most infrequent cause, and that 
most of the cases of jaundice are brought on by surfeits 
in eating or drinking: an excessive meal of meat will 
sometimes excite a jaundice. Where it is not attended 
with pain, or extreme sickness, or considerable soreness 
from pressing on the liver, which are symptoms attend- 
ing inflammation, scirrhus, or large collections of gall 
atones; it yields to mild treatment. 

I strongly suspect the notion of gall stones obstructing 
the biliary ducts, and being the cause of jaundice, is not 
often well founded; but that those concretions in the liver 
produce inflammation, which interferes with the healthy 
secretion of bile. See inflammation of the liver and 
scirrhus. 

I now proceed to detail the treatment for simple jaun- 
dice: Give the patient, if an adult, one scruple of ipeca- 
cuanha combined with ten grains of calomel; if it pro- 
duces vomiting, drink weak tea, or warm water, as usual. 
Repeat this every other day, till three doses are given, 
if necessary. If the jaundice is attended with fever, it 
will be advisable to bleed the patient moderately. On 
the intermediate days of taking the above medicine, take 
of these pills, rhubarb one dram, castile soap one dram, 
syrup or molasses enough to form pills; make twenty- 
four pills; and of these give four per day. The patient 
must live on a light vegetable diet, as well-boiled rice, or 
barley, roasted apples, sallads, &c; light broths may be 
used; greasy articles are to be avoided; milk may be used; 
and, perhaps, the sour is best. For drink, toast and wa- 
ter, or apple water, or any mild herb tea, cool, or even 
water, provided it is not rashly used, or near the time of 
taking the ipecacuanha and calomel. 

Moderate exercise is never to be dispensed with. The 
above treatment will be safe in jaundice from any cause. 



S36 OF A DIABETES. 

\ 

but if it should not relieve, advice must be had. If there 
is an abatement of the symptoms, the same treatment 
might be continued a while longer, leaving longer inter- 
vals between the doses of ipecacuanha; and continuing 
the pills; should too severe purging arise from the me- 
dicine, a moderate anodyne at night, as half a grain of 
opium with two or three grains -of ipecacuanha, will be 
found useful. 

SECTION XXXIII. 

Of a Diabetes. 

The characterizing symptom in this disease is a too 
copious discharge of urine, mostly of a sweetish taste, 
and which will yield a species of imperfect sugar; but 
sometimes no particular difference is discoverable in the 
taste of the urine; it is said always to lose its urinous 
smell; this increased discharge is attended with thirst, 
feverishness, lassitude, pain in the back, heat, and unea- 
siness in the belly, costiveness mostly, sometimes a swel- 
ling of the hips and loins; and, when inveterate, a frothi- 
ness about the throat and mouth; to these succeed a rapid 
wasting of the whole body. It has been supposed that 
the seat of this disease is in the stomach; and from opi- 
nions respecting the functions of the liver, delivered by 
Dr. Rush, it has been supposed to be seated in that vis- 
cus: both opinions were founded on a belief, that the 
proximate cause was an imperfect assimilation of the 
food to the necessary animal properties. That is, the 
stomach or liver, was supposed to be impaired in their 
functions, so that the food was not duly prepared before 
it entered the circulation, and therefore, the various parts 
through which this imperfect blood was carried, could 
not elect particles suitable to their purposes, and that the 
kidneys strained or took up this crude matter, and pas- 
sed it out of the body. 

This disease most usually attacks great eaters and 
drunkards. I think most persons who feed too much are 
more or less affected by this disease. It has generally 
been reckoned an incurable disease. Astringents have 



OF MADNESS, ©R INSANITY. 237 

been tried; a diet of animal food lias been recommended, 
but I believe, these things have seldom succeeded. Se- 
veral cases are on record of cures being effected from the 
free use of the lancet, such as bleeding once a day till 
the symptoms are abated, or till from fifty to upwards of 
a hundred ounces were drawn. This was accompanied 
with a diet suited to the case, being light, but partaking 
more or less of animal food, as there was more or less 
fever. Other cases are on record, where the frequent 
repetition of vomits has succeeded. 

Upon the whole, this is a dangerous disease, and re- 
quires the best advice. I would, however, advise per- 
sons deprived of medical aid, to bleed once or twice pret- 
ty largely, then take a couple of vomits, three or four 
days apart; live principally on light animal food; and 
take before every meal, two or three tea spoonfuls of 
beef's gall, either mixed with a little milk, or the gall 
dried in a pan set in water, which will prevent it from 
burning; of this a large tea spoonful may be mixed with 
a little milk, and taken as quickly as possible. If the 
bowels are costive, glysters should be used, and if a 
dangerous diarrhoea occurs, give small doses of lauda- 
num. 

SECTION xxxiv. 

Of Madness, or Insanity. 

There is much variety found in this deplorable condi- 
tion of man, such indeed is the variety, that I shall not 
attempt, here, either a detail of its various forms, nor 
yet of its cure. My design is merely to suggest, to per- 
sons unacquainted with such maladies of the mind, that 
many cases arise from diseases of the body, and are 
often removable by medicine, or other treatment. Its 
causes appear to be various, as intemperance, intense 
study, or violent passions, and perhaps sometimes con- 
stitutional predisposition, long continued fevers, certain 
conditions of the uterus, affections of the mammae: it 
often alternates with other diseases, as consumption. 
Most of the causes of madness impair digestion; and 



238 OP MADNESS, OR INSANITY. 

how sensible are we all of the influence of the mind over 
the stomach! In vain we look for appetite while the 
mind is agitated with the passions, with intense thought, 
or strong desires. These considerations lead me to be- 
lieve, not only that intense study, &c. produces madness, 
by operating primarily on the stomach, but that many ca- 
ses of madness have their seat in the organs of diges- 
tion, as the stomach, liver, and spleen, and here, as in 
many other cases, the mind is only sympathetically af- 
fected. 

From the vast number of diseased brains found on 
dissection, where no madness existed, I think it highly 
probable, that organ is not the most common seat of mad- 
ness; and that a destructive, or ineffectual treatment has 
been a frequent consequence of a different opinion: and 
which led to severe treatment about the head, while per- 
haps, this faithful monitor disclosed the insidious dis- 
ease of the liver, spleen, stomach, uterus, mammae, or 
perhaps, in some cases, parts of which we have yet no 
suspicion. 

Upon the whole, I suspect, that although insanity, in 
many cases, arises from local affections, yet, the general 
system is not only diseased, but partaking of a pecu- 
liar diathesis, or species of action essentially connected 
with the insanity; and that to effect a cure we must ge- 
nerally operate on the whole constitution; and not as soon 
as irregular ideas are discovered, attack the head with 
violence. What blisters! What cold clay caps! What 
cold affusions! What ice! What shaving, cupping, &c. 
have been applied to the human head; sometimes, no 
doubt, much to the advantage of the patient, but in a 
majority of cases, perhaps, for operations of the mind 
wholly sympathetical; and which can only be reached by 
remedies which operate on the whole system. 

I think insanity often curable, and mostly a disease of 
the whole system, for the following reasons. I have 
known a case, where after deplorable madness of seven 
years standing, the mind spontaneously recovered, and 
performed its functions regularly for many years; this 
worthy old man was at length attacked by a bilious re- 
mittent, which again impaired the faculties of his mind, 



239 

but being at a good old age, he soon glided to another 
world. Many have been restored by means, and by time 
alone: the great Boerhaave gives a case of a person who 
by the long use of whey, water, and garden fruits, eva- 
cuated a great deal of black matter, and recovered. Con- 
finement and solitude has often restored a deranged 
mind; and the weakness of the head, which often re- 
mains for weeks after fevers, gradually disappears as the 
general system gains strength. Now, if madness has 
been cured spontaneously, and by medicine too, even in 
one case, why may we not hope for it in all, and never 
cease our efforts while there is life. 

We seem to have been misled in our views of madness 
from its resemblance to delirium, as respects the mind, 
and because the mind recovers its functions when fever 
goes off, we are ready to conclude that madness is essen- 
tially different, because no sensible signs of disease at- 
tend confirmed insanity. But do we not find in every 
department of nature, things subject to a variety of mo- 
difications which render their sensible signs invisible? 
Thus the matter of heat enters into a variety of combi- 
nations, and is so completely latent, or hidden, as to have 
eluded the observation of mankind, for several thousand 
years. Light enters into myriads of bodies, and loses 
its sensible properties, giving life and colour to all the 
vegetable kingdom; but leaving no distinct evidence of 
itself as light. Diseases often invade the body so slowly, 
that we have no notice of them till far advanced, as ossi- 
fications, and aneurism of the great arteries, yet doubt- 
less, even these are often the consequence of general, de- 
bility, or of general disease. A slight wound which was 
scarcely recognized by the general system, nevertheless, 
will sometimes invade slowly and imperceptibly, and no 
matter what part of the body was touched, a certain set 
of muscles are violently attacked, and tetanus follows; 
if a slight wound in a remote part of the body always 
affects a certain set of muscles, when tetanus arises, why 
should we doubt, but, that, causes which elude our ob- 
servation may produce this chronical delirium, or de- 
rangement of the mind? Why are we not, then, m both 



240 OF MADNESS, OR INSANITY. 

cases, to apply remedies which operate, generally, on the 
body. 

Again, we know that many diseases do lurk in the 
body, and are only known by some local affections, as 
cancer, asthma, and palsy; the last disease often leaves 
all the natural and vital functions perfectly sound, so far* 
as we can see, for many years, yet in all those cases and 
many others, disease lurks in the whole system. In 
short, a great many diseases are sometimes hidden or im- 
perfectly expressed; fevers often assume this insidious 
character. Persons have often been seen walking in the 
last stage of yellow fever, and sometimes conscious too 
of their situation, but free from sensible signs of disease: 
a case is on record, of a lady in Baltimore, who rose a 
very short time prior to her death, and made prepara- 
tions for her funeral. Surely all those things go to esta- 
blish the fact, that there is a lurking disease in mania, 
and there is strong grounds for believing the brain, or 
any part of the head, is but secondarily affected: and if 
so, while we direct all our efforts towards the head, we 
will often be disappointed, in our efforts for relief. There 
are many cases on record, where transient lucid inter- 
vals followed bodily pain, as whipping, and other severe 
treatment. Such people, too, are less sensible to cold 
and hunger; all which shows the body to be out of its 
natural state. 

Upon the whole, then, I think there is strong grounds 
for believing, that when the nature of this dreadful ma- 
lady is better understood, or, perhaps, with prevailing 
notions of it, the day may arrive, when man shall not be 
abandoned, because he is unable to help himself. Let 
us then view every maniack as labouring under some 
disease and never abandon them. Persons have been cu- 
red of all other chronick diseases; and if madness has 
sometimes cured itself, spontaneously, after several years 
continuance, why should we ever relinquish our efforts? 
We know that other inveterate diseases, after resisting 
every effort for years, have afterwards yielded to the most 
trifling things; and why may not this be expected in 
madness? If our efforts prove abortive, let us desist for 
weeks, months, or even years, as circumstances may seem 



OF MADNESS, OR INSANITY. 241 

to direct, and then try again and again. While there is 
life there is hope, is the language in other diseases; and 
shall the poor maniack remain without hope, without 
effort? 

It is a truth that, many of the affairs of mankind that 
are supposed most settled, and thought even self-evident, 
are the greatest errours upon earth; and when found to 
be such, we are astonished at our ignorance. How long 
was the whole philosophick world misled by the notion 
of four ebments? The mind now beholds with wonder, 
that ages of mankind should have viewed water as an 
element, when it was decomposing every hour in the day, 
as in evaporation, in giving substance to plants, &c. 

Let not envy tax me with arrogance or vanity: if I am 
mistaken, I err on the safest side, and humanity guides 
my pen — she hangs upon my elbow, while suffering ma- 
niacks arrange themselves around my chair — their ges- 
tures swell my bosom with anguish — and I can ease my 
heart but with tears which I sfyed over this my feeble ef- 
fort, to excite attention to the pitiable maniack. Who 
can behold the giddy, the wicked sport of boys, pointed at 
the travelling maniack, and withhold the tear of pity? If 
angels weep, it must be at such a sight. And shall cold, 
languid pity, ease thy heart at his suffering, without an 
effort to relieve him? What, though the mind, clouded 
by a diseased body, cannot repel the offence, the great 
Giver of mind will in due time remove the cloud, when 
the distorted features shall change, and shine brighter 
than the sun, more placid than the moon, and put to 
shame and derision the silly mocker. But ah! again my 
heart doth swell, and the big tear rolls down my cheek; 
for with all its horrours stands before my imagination 
thousands of human creatures immersed in the gloomy 
cells of hospitals — unpitied, unnoticed, and untried — 
their bodies chained or confined to a cell — while the soul, 
perhaps unspotted, is tortured by bodily disease, against 
which no efforts are made. 

Let me admonish every keeper of an hospital, every 
physician, and every relative, that it is a duty which they 
owe their Maker, a suffering fellow -creature, and them- 
selves, to leave no means untried: if we fail in our efforts, 
31 



24& OF MADNESS, OR INSANITY. 

give the system time to recover, and try again and again: 
bear in mind the great precept of our Saviour, that you 
are not only to forgive your brother seven times, but sev- 
enty times seven. And if we find extreme difficulty, 
from the strange perversity of such persons, let us not 
neglect him on that account; it would seem as though 
nature rendered him thus perverse that we should be 
prompted to relieve him, and thus get rid of his vexa- 
tious conduct to ourselves. 

With justice may the anxious physician exult, that 
heaven has given him the victory in cases where he has 
apparently rescued a fellow creature from the grave, by 
the suitable means; but how doubly thankful, how ex- 
alted, and how blessed will be the lot of the physician 
who shall conquer this horrible disease. Already, me- 
thinks, I see the humane physician bringing from the 
long- forgotten cell a trophy of his skill — leading the new- 
born fellow-creature to his former connexions with the 
world. — Prayers! thanks! and rejoicings! shall ascend 
on high; and while I contemplate the scene but in ima- 
gination, I seal this humble effort for the insane with 
tears of joy. 

The learned Dr. Mead gives an affecting account of 
the case of Nebuchadnezzar, who, losing his reason, rov- 
ed about seven years with the beasts of the fields; and 
then recovered to acknowledge his dependance on a kind 
Providence, and also to understand the relation in which 
he stood with the world. 

As this book may possibly fall into the hands of phy- 
sicians, and especially as this is a disease much neglect- 
ed, because often considered incurable, I shall conclude 
this article, by offering a few queries. 

What would be the effect of slight, long continued 
nausea, brought on by safe articles, as ipecacuanha? 

What would be the effect of long confinement to one 
simple article of diet? 

What would be the effect of long continued, but slight 
pain, from setons, blisters, &c? 

What would be the effect of abstinence bordering on 
starvation? This cruel remedy should not be continued 
too long. 



OF THE CHOLERA MORBUS. 243 

What would be the effect of using vegetable tonicks. 
^iven to a greater extent than has been practised hereto- 
fore? 

The following course has often succeeded in the prac- 
tice of a brother of mine. Reduce the patient, according 
to circumstances, by bleeding, purges, and vomits, and 
very strict diet; then put the patient into the warm bath 
as long as it can be borne: take him out speedily, and 
throw a bucketful of cold water over the head; this gives 
a terrible shock: it is, however, not only safe, but has 
often proved effectual. 

What might be the effect of obliging such patients to 
be sickened daily by whirling round? 

What the effect of obliging them to walk on the highest 
possible places, apparently dangerous, but having them 
sufficiently secured from danger? 

What effect from the greatest possible frights, from va- 
ried means! Lastly, all severe means should be used but 
for short periods of time, and under the direction of per- 
sons of skill, lest our efforts turn to cruelty operating 
without hope. 

SECTION XXXV. 

Of the Cholera Morbus, 

This appears to be a colick of a high grade, so that 
the force of the disease prostrates the stomach and bow- 
els at once below that state of sensibility, which gives 
pain, as in common colick. Cholera is often a symptom 
of malignant fever, and therefore requires great caution, 
more especially as it is a disease of great danger, and 
speedy of termination. It is known by a violent purg- 
ing, and vomiting, sometimes bilious, at other times acid 
vomitings with very loose stools, accompanied with ex- 
treme debility, in a short time after the attack; it most 
frequently, according to my observations, occurs in warm 
weather, and at night. 

It is always dangerous for the unskilful to use evacu- 
ations in a cholera, and where it is the only disease 
they are seldom if ever necessary. Chamomile ten 



g44 OF THE C0LICK. 

should be drank freely, and it may also be given in glys- 
ters; soon as there has been a reasonable number of 
motions, or evacuations upwards and downwards, we 
may suppose the stomach sufficiently cleansed, and com- 
mence the following: take a table spoonful every fifteen 
or twenty minutes, till the disease is abated, or till the 
whole quantity is taken. If the third or fourth dose does 
not check the vomiting, ten or twenty drops of lauda- 
num must be given with each dose: take soda two scru- 
ples, rub it fine and add eight table spoonfuls of cold 
mint water, or three or four drops of essence of pep- 
permint may be rubbed with the soda before it is mixed 
with the water. If chamomile is not at hand, centaury, 
carduus, or mint tea will often answer. Soda water 
highly charged with fixed air may be taken freely. If 
the disease still progress, apply a blister over the sto- 
mach; sinapisms to the feet; and if the physician is not 
to be had, take a little strong well made coffee, a little 
good wine, or even strong brandy, but be cautious how 
you use stimulants, unless you are well satisfied no fe- 
ver is lurking in the body. If the case is lingering, 
but not very violent, small doses of calomel should be 
used. Toast and water, weak cool bitter teas, or good 
porter and water, will make the most suitable drinks, 
and the patient must return to his former diets with 
great caution, beginning with light broth, or good coffee 
or tea, with a little relish of nice salted meat or fish, 
and water biscuit, or good bread. Should soda not be 
at hand, half a dram of salt tartar may be used in its 
stead. 

SECTION XXXVI. SUBSECTION I. 

Of the Colick. 

Colicks, usually so called, are the bilious, lead, fla- 
tulent, hysterick, and the iliac passion. I shall treat 
of them briefly in the order in which they have been 
named. Bilious colick differs in nothing from a com- 
mon colick, but that it occurs in bilious habits. Its usual 
exciting causes are surfeits, from eating or drinking, from 
neglected costiveness, or from rash exposure to cold 



OF THE LEAD COLICK. &45 

moist air, and damp or wet feet. The symptoms are 
some fever; pain in the bowels, which seem drawn to- 
gether: if the pain abates, now and then, it returns with 
a sharp pain as though something was piercing through 
the parts; severe vomiting of bile, bowels generally ob- 
stinately costive, sometimes loose bilious stools. 

Bleed once or twice, according to circumstances, give 
opening injections freely, open the bowels with rochelle 
salts, salts and manna, and if the case is obstinate, give 
calomel in large doses. If costipation withstand all those 
remedies, throw up large quantities of warm water, by 
means of a large bladder, two or more gallons may be 
injected; if this does not succeed, give an injection, con- 
taining a little tobacco juice, got by boiling a little tobac- 
co in water. Or, if possible, by means of a large blad- 
der, throw up tobacco smoke, till the patient becomes 
sickened with it. In obstinate cases, very large doses of 
opium will sometimes succeed, as two or three grains, 
repeated at short intervals, till the pain entirely abates; 
but those violent articles ought not to be used without 
good advice, if it is to be had. 

Where advice cannot be had, provided due caution has 
been observed in not jumbling too many things together, 
and always allowing a reasonable time for remedies to 
act, it will be safer to proceed than to wait too long on a 
physician, for skill cannot avail if the disease is too far 
advanced. Bilious colicks sometimes arise from vitiated 
bile which excoriates the rectum, and tinges the skin of 
a yellowish hue: here we must use gentle vomits, and 
small doses of calomel; and also mucilaginous liquids 
by way of glysters, and for drinks. 



SUBSECTION II. 

Of the Lead Colick. 

Lead colick, or such as arise from working among lead. 
To the usual symptoms of colick, are added here, spasms 
of the whole body; these soon terminate in palsy. In 
this colick it should always be remembered, that lead is 
only injurious so far as it is acted on, and divided by 



S46 OF THE FLATULENT COLICK. 

acids, therefore, every thing acid must be. avoided, and 
this caution applies not only to such persons as work in 
lead, when diseased, but at all times, they should as 
much as may be consistent with circumstances, avoid ve- 
getables, more especially acids: potatoes, onions, old 
well-made wheat bread, with rich broth, in small quan- 
tity, and animal food, with oily articles: always remem- 
bering, that much smaller meals of such articles are al- 
lowable than of vegetables. Taking a little good sweet 
oil before going into lead works, is always advisable. 

When this colick comes on, large quantities of warm 
mucilage should be thrown up the bowels, and also drank, 
for this purpose, slippery elm bark, flaxseed, or water 
melon seed may be used; or considerable quantities of 
nice oil, or nicest fresh butter melted, should be taken 
and succeeded by large quantities of warm water, by way 
of glysters. The parient should be put into a warm 
bath, and this must be repeated according to circumstan- 
ces. One part balsam copaiba, and three parts castor oil 
should be given in doses of a large spoonful; or a spoon- 
ful of castor oil, with thirty drops of balsam peru, every 
two hours, till the bowels are open: if the stomach rejects 
this medicine, it may be given in glysters. If the pain 
is violent, and does not yield to the above treatment, 
opium may be given in full doses till the disease abates. 
Toast and water, or onion tea will be the best drinks; or 
a very weak infusion of peruvian bark. Where this 
disease comes on persons not long subject to lead fumes, 
and of good habit of body, bleeding may be useful; but 
we should not repeat it often. 

SUBSECTION III. 

Of the Flatulent Colick. 

This is a mere collection of sharp air in the bowels, 
arising from indigestion, surfeits, too much acid food, or 
malt liquors. It is known by severe pain in the bowels 
with rumbling of wind, or discharges of wind upwards. 
If it is taken early, a few drops of essence peppermint. 



OF THE HYSTERICK COLICK. %-VJ 

<*r spearmint, or a little strong tea of either of those 
herbs: or a little ginger tea, or a little soda or salt tar- 
tar, dissolved in water, and taken in small doses, with 
bathing the feet in warm water, will generally relieve. 

These things will be found to answer the purpose 
much better than spirits of any kind, which may do a 
great deal of mischief if inflammation or fever exists. 
Calamus tea has often been used with advantage. Or a 
few drops of laudanum, with an equal quantity of sweet 
spirits of nitre, will generally succeed. The patient 
should eat sparingly for a few days; and take a little 
salts and manna, or rochelle salts: vegetables should be 
used but sparingly: for drink, toast water, or cold weak 
infusions of pleasant bitters. 

SUBSECTION IV. 

Of the Hysterick Colick. 

This disorder has, added to the symptoms of flatulent 
colick, agitations of the mind, and a sense of suffocation, 
from a sensation as though a ball was rising up into the 
throat, and generally attended with a vomiting of green- 
ish matter. A gentle vomit of white vitriol, or ipecacu- 
anha should be given, and as soon as it operates, large 
quantities of very weak tea should be drank; and when 
the stomach is composed again, ten or fifteen drops of 
laudanum should be given in weak ginger tea, or any 
other pleasant tea: and repeated frequently till the colick 
abates; the bowels should be opened by mild glysters. 
If attended with fever, it may sometimes be necessary 
to bleed moderately. A few drops of ether, or. equal 
parts sweet spirits nitre and spirits hartshorn, in doses 
of twenty to thirty drops will often succeed. These 
palliatives should be followed up with pills of iron filings 
and assafcetida: where assafcetida is particularly offen- 
sive, a few grains of saffron, or camphor may be added. 
and the bowels in all cases must be kept open, with mild 
articles, as magnesia, or rhubarb. A little decoction of 
bark, or infusion of gentiau may be used occasionally: 
all spirituous drinks or strong teas are carefully to be 



-$•18 OF THE ILIAC PASSION. 

avoided. The diet should he light but nourishing, as 
good coffee, with a little relisher of salted dried beef, 
nice ham, venison, or good salted fish; plain broth with- 
out much vegetables, light meats, poached eggs, a little 
nice butter, good wheat bread: a little garlick, and pota- 
toes may be used. The drink should in general be wa- 
ter, or sometimes a little good wine; weak cold infusions 
will be the best drink, where there is objection to water, 
and chamomile, bark, centaury, or carduus, will answer 
for this purpose. 

Women disposed to hysterical affections should encou- 
rage cheerful company; reasonable amusement with con- 
stant but moderate exercise, must not be neglected. Go- 
ing abroad frequently to the house of an agreeable neigh- 
bour, and encouraging them to exchange visits, will 
always be found useful. 

SUBSECTION V. 

Of the Iliac Passion. 

This is a violent disease of the bowels, wherein the 
whole order, or action of the bowels seem to be changed, 
so that they, instead of carrying the feces downwards, 
turn it upwards into the stomach; and from thence it is 
vomited with all the disagreeable qualities of common 
feces. There is generally severe pain at first; and great 
prostration of strength, and obstinate costiveness attend. 
This disease mostly arises from ruptures, from wounds 
or bruises on the abdomen, or from common colick ter- 
minating in introsusception, or one gut running into ano- 
ther till they become confined, strangulated, and infla- 
med. 

If it arises from a-strangulated rupture, the first thing 
must be to reduce, or return the part which has escaped 
from the abdomen. In general, if taken early, it will be 
proper to bleed pretty freely; then apply gentle pressure 
to the tumour; if this will not succeed, inject as much 
warm water as possible into the bowels; apply cold wa- 
ter to the ruptured part for a few minutes, then try to re- 
duce again, always guarding against rough handling of 



OF AN EPIDEMICK COLICK. 349 

the parts: if this does not succeed, force tobacco smoke 
up the bowels; raise the patient's thighs high and dash 
cold water over his feet, or over the tumour. 

If this disease proceeds from injuries of the abdomen, 
we must place much of our dependance on frequent 
bleedings, warm mild injections; and if the case is early 
attended to, opium may be used freely to compose the 
stomach, even while we use the lancet. No nourish- 
ment should be taken; the patient may drink freely of 
mucilaginous drinks, as milk and water, slippery elm wa- 
ter, barley water: or toast and water will sometimes be 
suitable; a single mouthful of bread, or other solid food 
in such a case, may occasion death. 

If it arise from common colick, bleed moderately, and 
use the treatment recommended for bilious colick. See 
also the article on enteritis, or inflammation of the in- 
testines. 

SUBSECTION VI. 

Of an EpidemicJc Colick. 

I have seen colick prevail in three successive years, 
as an endemick, during the whole of the winter and spring 
months. This constitution of the weather, had been pre- 
ceded with unusual prevalence of remitting and inter- 
mitting fevers; these were succeeded by two summers of 
dysentery, somewhat inflammatory. And the colicky 
constitution was succeeded by insidious typhoid fevers, 
accompanied with catarrhal affections of the breast. 
This colick was a painful obstinate disease, much dis- 
posed to return on those who had been once affected. I 
had "tried various methods of cure, but am inclined to be- 
lieve, the following was the most successful: Frequent- 
ly repeated mild injections, mild purges attended with 
anodynes; a mixture of castor oil, and Godfrey's cordial, 
or rochelle, or epsom salts, generally were the best pur- 
gatives: if the pulse was active bleeding once or twice 
was useful. A thin light but nourishing diet was best: 
drinks were given of toast and water, chicken water, 
weak teas. Out of a vast number of patients thus treat- 
32 



%50 OF AN H^MOPTOB, Oft SPITTING OF BLOOB. 

ed, I never lost a single one. In one obstinate case, 
benefit was derived from the use of large quantities of 
warm water thrown up the bowels, by means of a tube 
connected in the usual way, to a large bladder, but about 
twice the length of the common tubes. In one case re- 
lief could only be obtained by means of the tobacco 
smoke. If no better means are at hand, for using tobacco, 
it will be advisable to cause the patients to breathe air 
containing tobacco smoke, till they become sick at 
stomach. 

Upon the whole, no disease will bear a more free use 
of opium, than all kinds of colick; all violent cases are 
attended with spasm, and this is often increased by pur- 
gatives, if they are not accompanied with opium. Pur- 
ges are very liable too, to irritate the stomach, and pro- 
duce vomiting. Stimulant injections, as a handful of 
salt added to the usual quantity of water, or a strong de- 
coction of senna, should be given now and then, and in 
the intervals very frequent repetitions of the mildest 
glysters. If pain does not yield kindly to opium, bleed; 
and blister over the abdomen. 

I recommend this treatment from extensive experience 
in those affections. But I must admonish the reader, 
that colick is sometimes but a symptom of violent dis- 
eases, either manifest throughout the whole body; or 
the disease is locked up or misplaced, so as not to be 
discernable, but from the circumstance of some malig- 
nant epidemick being prevalent; or by the skill of aw 
experienced physician. 

SECTION XXXVII. 

Of an Hcemoptoe, or Sjritting of Blood. 

SUBSECTION I. 

Spitting of Blood from the Lungs. 

This disease is most commonly a vicarious one, and 
arises from obstructed menses, or habitual bleeding poles, 
bleeding at the nose, &c. It is, however, often a prima 



OF AN H.EMOPTOE, OR SPITTING OP BLOOD. 351 

vj disease, and also sometimes merely symptomatica, as 
in consumption. It is particularly dangerous in persons 
predisposed to consumption. It may be excited by vio- 
lent exertions of the lungs; by obstructed perspiration; 
cough, and other causes. It is a thing never to be de- 
sired; inflammation of the lungs, or any other disease 
can be much more safely relieved by bleeding at the 
arm, by setons, and other evacuations from the body. 
Therefore, as soon as this hemorrhage occurs, from 
whatever cause, we should take common salt in its dry 
state, freely, till it is checked; and if symptoms of fever, 
plethora, or pain in any part of the body attends, we 
must bleed in small quantities, and repeat it frequently 
till the bleeding from the lungs ceases. The body may 
be reduced a little by mild diet and gentle purges; and 
in full habits, a slight nausea should be kept up for a, 
few days. Where it is evidently the translation of some 
other disease, we must refer to the respective maladies 
from which it arises, and treat it on general principles. 
It may be distinguished from a spitting of blood from 
the stomach, by these symptoms: some warmth, or a 
languid or feeble like sensation is felt in the breast; the 
heart immediately sensible of the breach, in the lungs, 
palpitates, and if fear attends, this is augmented; a lan- 
guid loose cough comes on, and florid thin blood is spit 
up. There is generally considerable tightness felt 
through the breast, and a flash of heat runs over the bo- 
dy: if the case is severe, chills are also present. Where 
a simple hcemoptoe, occurs in delicate habits, depletion 
or low diet must by no means be continued more than a 
few days; and if it is even found necessary to bleed, 
which we must never omit while the lungs bleed, we 
should at the same time advise a light but nourishing 
diet in small quantities: give tonicks as nitrick acid, or 
elixir vitriol; or decoctions of bark, or cherry tree bark. 
The patient should use constant, but gentle exercise in 
the open air when the weather is good; dress warm, 
avoid stooping, laughter, loud singing, or reading; or 
sudden gusts of passion, or sudden motion. But the 
lungs should be reasonably exercised by speaking or 
Very gentle swinging. 



%%& ©F BLOODY URINE. 

SUBSECTION II. 

A Spitting of Blood from the Stomach, 

This is generally owing to a rupture of a vessel in the 
stomach; and the hemorrhage is known by the blood be- 
ing dark coloured, and attended with heat or pain in 
the stomach, mostly accompanied by considerable chills 
and heat: if the discharge is great, it becomes of a bright- 
er red, but still there is no particular affection of the 
breast. This is almost always but a symptom of some 
other disease, to which we must turn our attention. Ma- 
lignant fevers often lead to hemorrhage from the stom- 
ach. All stimulants must be avoided,: mild mucilaginous 
drinks must be given; the patient bled, if there are no 
contraindications; give small doses of rochelle salts, or 
e som salts, or cremor tartar with mucilage of gum ara- 
bick; and when the bowels are opened with these, assist- 
ed by injections, give a few doses of nitre. But, in gen- 
eral, we may rest the treatment principally on repeated 
bleedings, cooling mucilaginous drinks, with a little ro- 
chelle salts. The patient ought to take but little food, 
and this should consist of milk, or mild vegetables, for 
some days after recovery. In alarming cases of this 
kind, I would give common salt, as recommended for 
spitting of blood from the lungs; or three, four, or five 
grains of sugar of lead. 

section xxxvm. 

Of Bloody Urine. 

This disorder, perhaps, never exists as a primary af- 
fection of the whole body, but is accidental, arising from 
stones lodged in the kidneys, or bladder, or from inflam- 
mation in the kidneys, as in smallpox. In our efforts 
for its removal, we must act on general principles, go- 
verned by the disease, or prominent symptoms. But in 
general, the very liberal use of mucilage, as that of gum 
arabick, slippery elm, or flaxseed, or even milk and wa- 



OF A BLEEDING AT THE NOSE. 253 

ter, with emollient glysters; and if much pain attends, the 
warm bath, or opium, or bleeding, according to circum- 
stances, will be proper, provided no general disease is 
present to contraindicate their use; all stimulants are to 
be avoided, but especially, regard must be had to the 
disease from which it proceeds. 

section xxxix. 
Of a Bleeding at the Js"ose. 

A bleeding at the nose is often ^ symptom of other 
diseases, as scurvy and other disorders; whatever mate- 
rially depraves the fluids, or hurries the circulation, will 
occasion a bleeding at the nose, in persons predisposed 
to this hemorrhage. Where this occurs in healthy bftbitg* 
there is no danger to be apprehended; it may sometimes 
be useful to suffer it to bleed a little. 

To check it, the face may be washed in cold water, 
and water snuffed up the nose. If this does not succeed, 
pour cold water on the neck: and immerse the genitals 
in cold water: and if the case has not progressed too far, 
bleed from the arm. The nostrils may be stopped with 
lint soaked in strong vinegar, or a cord passed from the 
mouth into each nostril; but this last is seldom necessa- 
ry. Should the case resist all those remedies, put lint 
up the nose, rolled in powdered blue-stone, and give a 
small dose of ipecacuanha, till nausea is excited. If 
clots form in the nose, they ought not to be removed for 
two or three days. Frequent small doses of nitre and 
cremor tartar should be given: cool drinks, with vinegar 
or fruit jelly: the bowels opened by glysters. if necessary. 
If the patient is diseased, reference must be had to the 
remedies proper for the disease from which the bleeding 
at the nose may arise. 

Bleeding piles will be found under the head of habi- 
tual diseases: and of bloody flux, I have treated already. 
It remains here, to give some general observations on he- 
morrhage. 



254* GBNERAL OBSERVATIONS ON HEMORRHAGE. 
SECTION XL. 

General Observations on Hemorrhage. 

I beg leave, in the most pointed manner, to differ from 
Buchan in his opinions respecting hemorrhage being 
most generally salutary, and therefore not to be opposed. 
This has been a prevalent notion, and is founded on the 
belief that, being the work of nature, it must be salutary. 
But is not almost all our prescriptions and remedies for 
dieases at open war with nature? In the case before us, 
the examination has been but superficial. Thus a dis- 
ease lurks through the whole system, depraving the flu- 
ids, or disease is situated in the uterus, or about the rec- 
tum, as in bleeding piles: owing to circumstances of some 
kind, these may be checked; the blood vessels receive a 
new stimulus; they make an effort to throw off this of- 
fending stimulus, now operating on the whole body; but 
disease is excited, and the blood, in its rounds through the 
-body, tries every part till a weak part is discovered, and 
there pours out blood at random. But does she always, 
or even in a majority of cases, choose parts that are safe? 
Does she not frequently pour out the blood into the lungs, 
stomach, and even the brain? And is it not safer, then, 
to assist her irregular efforts, and draw blood from the 
arm or foot? Do we not know that hemorrhage is often 
accidental, and having once, by a few repetitions, become 
habitual, that it is ever liable to be checked, and thrown 
on some part immediately essential to life? Why, then, 
suffer so dangerous and fickle a habit to be formed, which 
no prudence can confine, with any certainty, to any one 
part of the system? 

I am well convinced, after this habit is once formed, it 
would be dangerous to check hemorrhages too sudden- 
ly; but in no case can they be critical at their commence- 
ment, and therefore they ought to be attacked with spirit. 
I feel fully justified in saying, that spontaneous hemor- 
rhage is ever an enemy to the human constitution, if Jet 
alone. Besides, in this case, we may, without perver- 
sion of language, say> we follow up the hint given by na- 



GENERAL OBSERVATIONS ON HEMORRHAGE. 25§ 

tare, when we boldly attack hemorrhage. If nature 
shows you blood as an evidence of plethora, or dis- 
ease, why leave her to repeat those struggles? Why not 
rather take the hint, and abstract blood, or otherwise re- 
duce the system, and thus do more, in half an hour, than 
the natural operations in a month, or perhaps in a life- 
time? 

Moreover, such is often the violence which nature has 
to exert in translating hemorrhage from one part of the 
body to another, that fever, pain, and sickness, are the 
consequence; while one or two bleedings at such a time 
gives not only present relief from pain, but in a few days 
infuses new life and vigour into the whole system. These 
observations apply to active hemorrhages, or such as 
arise from a plethora, or inflammatory diathesis. 

It now remains to say a few words on passive hemor- 
rhages, or such as arise from direct debility: these are 
the consequence of depraved fluids, or languid solids, of 
the living system. Here nature, forsaking every friendly 
relation of the various parts of the body, would pour out 
the purple fluid of life; not only without reason or appa- 
rent design, but really prejudicially throw it away. True, 
it may be urged, she shows the danger lurking in the 
body, by presenting specimens of the blood; but, alas! 
where a tea spoonful would answer, she would waste 
quarts, and bring the sufferer speedily to his end. 

Upon the whole, I would advise those long subject to 
hemorrhages, to go on in the old way; but those who are 
threatened in that way, I would most seriously admonish 
them to attack every considerable hemorrhage with spi- 
rit, and never let prejudice induce them to believe, na- 
ture ever designed that man should bleed from the anus, 
nose, lungs, stomach, &c. This ridiculous notion comes 
from the well known habits of the female, whose constitu- 
tion was originally thus formed, but after all the menses 
are no hemorrhage but a peculiar secretion, as taught by 
professor Davidge, and hinted at by others. 

To conclude, although hemorrhages are to be treated 
in some measure according to the part affected, they 
should nevertheless, be considered and treated on gene- 
ral principles. 



256 GENERAL OBSERVATIONS ON HEMORRHAGE. 

All hemorrhages are either active or passive; active 
when proceeding from plethora, or an inflammatory dia- 
thesis; and perhaps all simple cases arise from plethora 
or fulness of the vessels, while the more active ones pro- 
ceed from some disease. The indications in all those 
cases are the same, differing only in force: they are de- 
pletion brought about by abstracting blood; hy increasing 
all the secretions, by means of purges: cooling mediciues, 
and diluting drinks: and by lessening the force of the 
heart and arteries by exciting nausea: and in the inter- 
vals, especially, by withholding the stimulus arising from 
full diet, which may stimulate either by its bulk, or too 
cordial or stimulating qualities. So that we must use 
mild vegetable or milk diet: and not stimulate unduly, 
even with those articles. 

On the other hand, passive hemorrhage is perhap* al- 
ways the consequence of some disease, and few of these 
are to be removed or relieved bv a sudden stimulus jdven 
to the blood or svstem. bv cordials or stimulating articles 
of diet. We must in general proceed slowly and cau- 
tiously, with light nourishing diet: never full nor gross; 
with mild tonicks. as the mineral acids: and vegetable 
tonicks. as bark, and all pleasant bitters. 

After all. there is unquestionable evidence of the mine- 
ral tonicks having arretted hemorrhages, both active and 
passive, until remedies more permanent, because opera- 
ting more generally, were used. Among these are sugar 
lead, in do^es of two to five grains, with a little opium: 
white vitriol and opium. I beg leave to observe lastly, 
that every person subject habitually to hemorrhage, is in 
some measure an invalid: and therefore, every one threat- 
ened with this crippling of the constitution, should get 
the best advice: and boldlv resist this unfriendly °:uest. 
And where the habit is in good measure formed, by pur- 
suing a proper regimen, and wearing a seton. or issue for 
a length of time, this bad habit may be removed. 



OF VOMITING. 257 

SECTION XLI. 

Of Vomiting. 

Vomiting proceeds from a great variety of causes; it 
is a symptom of most diseases, as fevers, colicks, obstruc- 
ted secretions from sudden debility brought on by blows, 
on the elbow, on the head, or from the sudden abstraction 
of blood. It is, however, often brought on by mere surfeits 
in eating, or drink, by sailing, whirling round, and many 
other causes. In every case of vomiting we must, if pos- 
sible, discover the cause and regulate the treatment ac- 
cordingly. There is a vomiting in some measure habi- 
tual to some persons, who, notwithstanding, in general, 
enjoy good health; but in all cases, if long continued, the 
constitution is much injured by frequent vomiting. For 
a vomiting brought on by disease, as gout, hystericus, 
colicks, injuries done the brain, inflammation of the kid- 
neys, intestines, liver; hj ruptures; inflammation of the 
stomach, or of the brain; from malignant fever, or chole- 
ra morbus; or from hemorrhage, we can only prescribe 
with the greatest circumspection, and never till we have 
carefully considered the disease from which it arose; and 
then prescribe on general principles, bearing in mind, 
■however, that even where it is but symptomatick, it must 
be appeased by suitable drinks, glysters, warm stimu- 
lants applied outwardly; by laudanum in small doses; 
ether, gentle emeticks, wine, brandy, aromatick teas; or 
cold infusions of aromaticks, as cinnamon, mint; lime 
water and milk, a little strong coffee, weak solutions of 
soda, or salt tartar, more especially impregnated with 
fixed air or carbonick acid. It must be evident, that 
much skill is necessary to apply such a variety of articles, 
differing so widely in their qualities, even with safety. 
But if we bear in mind, that we are always to stimulate, 
or lessen the excitement of the stomach, we can proceed 
with considerable certainty: thus in gouty habits, in hys-/ 
terical cases; and in intemperate persons, we must stimu- 
late according to circumstances. In high excitement, or 
indirect debility of the stomach, known by the disease 

m 



S58 OF VOMITING. 

present, by the constitution, and habits of the patient; we 
must pursue an opposite course, and by bleeding, injec- 
tions, cool pleasant saline articles, with mild aromaticks 
lessen the force of the general circulation, and more es- 
pecially lessen the excitement of the stomach. 

Where the cause of vomiting is unknown, soda water, 
prepared chalk, lime water and milk, a few drops of lau- 
danum, or ether, with glysters, and outward applications, 
will be the safest articles; toast and water, carefully 
made, is also a valuable article in all cases. A vomiting 
brought on by surfeits in persons not otherwise diseased, 
is most speedily removed by gentle emeticks, provided 
they are taken early; but if a cholera has come on it 
would be dangerous. Vomiting from injuries of the head 
generally yields to purging injections: that from hemor- 
rhage to rest, opium and cooling drinks: that from gout 
to laudanum, warm wine with aromaticks, or brandy, 
ether, tincture guaiacum, &c: that from hystericks to a 
gentle vomit, followed by small doses of laudanum with 
hartshorn, or -ether: that from inflammation in the kid- 
neys, to bleeding and mucilaginous drinks, with emol- 
lient glysters: that from a rupture, to its reduction. But 
for the treatment in all these cases, I must refer the rea- 
der to the respective diseases from which vomiting may 
arise. 

Vomiting from sailing, called sea sickness, seems to 
proceed from a disturbance excited in the brain, by the 
peculiar motion of the vessel, and the operation on the 
stomach is probably, a sudden loss of excitement and of 
its excitability, and this most likely extends to the whole 
system. It appears somewhat strange how a cause appa- 
rently so trifling, should so speedily prostrate the sto- 
mach, and whole system. That it proceeds from reduc- 
tion of excitement, I infer from the circumstances that 
no pain or inflammation, or local disease of any kind, ever 
follows sea sickness, and further, that depletion is neither 
useful, nor safe. It would appear as though the healthy 
connexion or affinities, between the excitability, and 
stimuli, was suddenly disturbed, and probably more par- 
ticularly in the article oxygen. Thus if we turn round 
suddenly, or swing suddenly through the atmosphere; or 



OF VOMITING. 359 

it* we stand on a dangerous precipice, we will find, by 
attending to the circumstances, that respiration is espe- 
cially interrupted, not by dispnoea, but by mere neglect 
of exercising the muscles of respiration; the lungs he in 
some measure idle; and the energies of the body ling lish 
for lack of the usual stimulus from oxygen. If these 
premises are correct, the following inferences may rea- 
sonably be deduced from them: 

1. That free exposure to open air, with so much exer- 
ercise as will rouse this torpor of the lungs, without in- 
ducing fatigue, is one of the principal remedies for this 
disease. 

2. However much the stomach suffers, it is the third 
point assailed by this distressing affection, first, the 
lungs, secondly the brain, and thirdly the stomach. And 
hence probably comes the inefficacy of all remedies ap- 
plied to the stomach; to remove all irritating substances 
from the stomach, by drinking warm water or chamomile 
tea, and afterwards taking small doses of laudanum, or 
very small doses, as two or three table spoonfuls of 
highly charged soda water will probably give some re- 
lief. But what would be the effect of inhaling vital air? 
Or who knows but stimulating the muscles of respiration 
might have a good effect? This might be done by means 
of electricity, or galvanism, or rubbing the spine, the 
sides, and abdomen, with spirits hartshorn, or washing 
those parts with a strong solution of salt amoniacum in 
good vinegar. I have already observed, in my treatise 
on consumption, that sailing was adapted to its inflam- 
matory stage: it would seem to follow, upon the whole, 
that turning round, and swinging of every kind, has an 
effect opposite to exercise in general, and therefore much 
mischief may arise from swinging consumpted patients, 
or those otherwise debilitated, except the debility be of 
the indirect kind, and we wish to reduce an inflammato- 
ry diathesis. It is true, in forcibly swinsrius: the oxv- 
gen is forced powerfully upon the lungs, but this excess 
of force on lungs debilitated, may be as little suited to a 
proper decomposition of the air, as the torpor, or inacti- 
vity of them, occasioned by sailing, and other causes. 
What might be the effect of frequent cold bathing (by 



260 OF A DIARRHOEA, AND OF A LIENTERY. 

pouring cold water over the body, or applying cold clothi 
to the thorax) in sea sickness? 



SECTION XLII. 

Of a Diarrhoea, and of a Lientery. 

A looseness, or diarrh'ma, may arise from a great varie- 
ty of causes, often from diseases, as acrid secretions of 
the liver, from debility in the stomach and bowels. But 
most commonly it is occasioned by catching cold, whereby 
the secretions are obstructed; or from eating or drinking 
articles which disagree with the first passages; and from 
irritation applied to various parts of the body, as teeth- 
ing in children, or worms irritating the bowels. 

It is wondrous strange it should ever have entered in- 
to the head of any man, that these discharges are sa- 
lutary, and therefore to be borne, and rather viewed as 
friendly companions. I admit, that to a person who has 
no knowledge of a suitable remedy for this complaint, it 
would be best to let nature alone. But this is no more 
the case in diarrhoea, than any other disease to which 
we are subject. The truth is, that in many cases nature 
makes an unavailing effort to carry off some offending 
matter within the body, but this is seldom proportioned 
to the case, being sometimes too sparing, and often too 
great. How are we to expect wonders from nature in 
curing our diseases, when Ave never pursue her most ob- 
vious tracts, when in health? A pretty specimen of fol- 
lowing nature indeed, search the globe for luxuries, 
gorge ourselves with trash, in food, in drink, and pour 
down hot, and then cold, &c. &c. and when nature 
would endeavour to throw off those dregs of imprudence 
or inattention, we are to call out, let nature alone and she 
will cure you, all your efforts in bringing on disease, to 
the contrary notwithstanding. And what a pretty com- 
panion she gi\ N es you, in sending you every half hour, 
perhaps, to enjoy the perfumes of your cloatick vault. 
She acts liere as the spoiled child, and the more you 
humour her, the oftener will she send you on this disa- 
greeable errand. 



OF A DIARRHCEA, AND OF A LIENTERY. S6l 

Let it not be imagined that I hold nature's efforts in. 
contempt; on the contrary, I would woo her ever as my 
guide, but not view her things without a scrutinizing, 
eye, in order to comprehend her real designs. Thus, 
if nature shows you by a diarrhoea, that there is lurking 
disease, why not take the hint she gives you, and carry 
off the offending matter by increasing the secretions from 
the use of purges, emeticks, sudoriiicks, and tempe- 
rance? Or, if nature is overpowered, as is often the 
case in all diseases, why not support, and aid her, by 
means of such articles as give tone or strength, and thus 
arrest wasting disease? Therefore, never let a diarrhoea 
run on; if you know the cause, remove it, if in your 
power; this you can always do in part. Then, if no- 
thing forbid, take purgative injections, or emeticks; live 
temperately: when this is dpne, try mild tonicks, as the 
mineral acids, bitter infusions, a little laudanum, &c. 

A purging is sometimes attended with pain in the 
bowels, some fever, and considerable thirst: in habits 
not subject to such complaints, or no particular debility 
to forbid, we should bleed moderately, give castor oil, 
rochelle salts, or other purges, once a day, or every 
other day. To conclude, mild glysters, gentle purges, 
temperate living, and dressing reasonably warm, will 
generally do more in a few days, than the natural efforts 
in a month, or perhaps in a life time. 

A diarrhoea that is in some measure habitual, will re- 
quire very little purging: mild glysters will generally 
remove the foulness of the intestines; then we are to en- 
deavour to give tone, by means of a suitable diet, and 
mild astringents, as bark, lime water, tar water, elixir 
vitriol, or pleasant bitter infusions; in these cases a 
reasonable use of old spirituous liquors, best wines, a 
little salted animal food, reasonable exercise, warm dry 
feet, will be found useful; so nmy a reasonable use of 
the bath, either cold, tepid, or warm. Lastly, it will 
generally be necessary to avoid a free use of vegetables, 
of malt liquors, large meals, wet or cold feet, damp 
beds, close rooms, &c. 

A lientery is a diarrhoea wherein the food passes off 
undigested; the food appearing whole, and in some cases 



S6g OP A GONORRHOEA, OR CLAP. 

running through the bowels in a few minutes. In these 
cases very gentle emeticks, weak solutions of soda, or 
tincture of rhubarb, may be given, and followed by the 
use of elixir vitriol, decoction of bark with magnesia; 
bitter infusions ofcarduus, centaury, or chamomile. The 
diet must be thin, light, and well boiled; an excellent 
diet in those cases is milk boiled with a little crumb of 
bread rubbed fine, and a little horseradish grated into it: 
ginger, mustard, and cinnamon, should be used mode- 
rately. 

It must be obvious, that in all cases of looseness, so- 
lid or harsh diet must be avoided, as well as full meals, 
and also the free use of spirituous drinks. I have said, 
cordial drinks are sometimes necessary; but to be useful, 
they must be used sparingly, or much injury will arise 
from them;*. they give a present stimulus, but debility 
will always follow if they are taken in large quantities. 

SECTION XLIII. 

Of a Gonorrhoea, or Clap. 

The cause of this disease is well known, and too of- 
ten encountered. Its symptoms are smarting in making 
water; a discharge of whitish, yellow, or even greenish, 
mucous matter, from the urethra. There is considera- 
ble difficulty in distinguishing this disease from its 
eldest brother, the pox, or lues venerea, and therefore 
it would always be best to apply speedily to an expe- 
rienced physician. If circumstances render that imprac- 
ticable, these circumstances may be remembered, that 
chancre or ulcer on the glans penis, is a strong symp- 
tom of lues; so is any very considerable inflammation, 
swelling, and pain of the glands of the groins. A run- 
ning, swelled testicles, inflamed groins, pain in mak- 
ing water, and fever, all arise, sometimes, from a clap: 
these symptoms, however, yield speedily to bleeding, 
oily purges, mucilaginous drinks, &c. while venereal 
buboes resist for some time every effort. 

Unless a clap is very mild, it is always safest to take, 
in conjunction with the remedies for this disease, a 



OF A HERNIA HUMORALIS, &C. 263 

little calomel and opium, for a few days. The inflam- 
mation in the urethra should be treated with mild injec- 
tions, for a few days, as milk and water, mucilage of 
best gum arabick, or very clean mucilage of slippery 
elm; then take one scruple of calomel, a tea spoonful of 
honey, and three or four ounces of water; shake this 
well together, and inject a syringeful of it three or four 
times a day. If priapisms are distressing, take lauda- 
num every night. If a gleet remains, take balsam co- 
paiba; and inject a weak solution of lead, as half a dram 
of sugar lead, in half a pint of water. These things, 
particularly, are to be attended to in clap; use a low 
diet, keep the bowels open with oil, or salts, or rhu- 
barb; take one full dose of jalap and calomel, bleed 
once; use mucilage plentifully; avoid venery and heat- 
ing drinks. And if there is any doubt of the nature of 
the disease, take calomel and opium, and use the calo- 
mel injection. 

SECTION XLIV. 

Of a Hernia Ilumoralis, or Inflammation and Swelling 
of the Testes. 

This is a painful swelling of the testes, accompanied 
generally with considerable fever. It arises from vari- 
ous causes, as a translation of inflammation from clap; 
from astringent injections in such cases; from mumps; 
very hard labour, &c. Where the symptoms run high 
from whatever cause it may arise, we must bleed large- 
ly and repeatedly; give mild opening glysters; cooling 
physick and drinks; enjoin rest, cold applications to 
the scrotum, as a cold poultice of bread with lead 
water, or slippery elm bark moistened. 

If the patient is able to go about, the parts must be 
suspended in a bandage in form of a cup, and tied with 
strings to a bandage round the body. In this disease 
we must never cease to bleed till the pain is entirely re- 
moved, unless constitutional debility, or constitution of 
weather prevails, which predisposes strongly to diseases 



264 OF A GLEET. — OF ONANISM. 

of a low grade; here, after reasonable bleeding, we 
must trust the cure to rest, cold applications, and opium, 
given according to circumstances. 

SECTION XLV. 

Of a Gleet. 

A gleet, or thin discharge from the urethra, may 
proceed from general debility, gout, or other diseases, 
but is more frequently the consequence of gonorrhoea or 
onanism. In our efforts at cure, the principal indica- 
tions are the same. Light but nourishing diet; the cold 
bath; riding on horseback and the use of tonicks; and 
the following will generally answer: take iron filings, 
assafcetida and myrrh, each one dram; make this into 
pills of the usual size, and take three or four daily; 
drinking after each some pleasant bitter infusion. Along 
with these, as constant remedies, the occasional use of 
balsam.copaiba, or small doses of tincture cantharides, 
will be proper. A hard bed, and moderate anodynes 
at night, will be advisable; and the bowels should al- 
ways be kept reasonably open. Anodynes should, how- 
ever, never be given for any length of time; a little bark, 
or powdered Colombo root, taken in cool water going to 
bed, would answer to alternate with anodynes. It must 
be obvious that where the cause is known, it must be 
avoided. Gleet* are sometimes accompanied with a 
smarting in the urethra; in those cases mucilaginous 
drinks should be taken, and very nice oil, or milk and 
water, injected into the urethra. 

SECTION XLVI. 

Of Onanism. 

This disease has been known for many ages, as we 
may read in Scripture of the case of Onan. Excess of 
venery is a dreadful and common cause of dangerous 
diseases, but self-pollution is tenfold more destructive, 
The excessive irritation which accompanies this act, ex- 



OF PHYMOSIS, AND PARAPHYMOSIS. 265 

hausts or racks every energy of the brain, which is con- 
cerned in the animal, vital, and natural functions, and 
the mind itself scarcely escapes. The first consequen- 
ces, in general, are parapisms, nocturnal emissions, 
gleet; these are followed by general debility, indiges- 
tion, hypocondriasis, and sometimes by paraplegia, or 
palsy of the lower limbs, and according to Tissot, and 
others, even instant death. 

No remedies Avill succeed in removing this disease 
while the cause continues, and the best cure in general, 
if it has not been suffered to progress too far, is matri- 
mony. If circumstances forbid this, by avoiding the 
practice which leads to this disease, and pursuing the 
plan laid down for gleets, we will generally succeed in 
making the patient tolerably comfortable. It is said both 
sexes suffer from this vicious practice. 

SECTION XLVII. 

Of Phymosis, and Paraphimosis . 

A phymosis is a painful contraction of the prepuce, or 
foreskin of the penis. Paraphimosis is a painful stric- 
ture on the glans penis, occasioned by a contraction, 
swelling and inflammation of the prepuce, which has 
been drawn back over the head of the penis. In chil- 
dren, those affections arise from a variety of causes, as 
uncleanness of the parts, irritation from handling with 
dirty fingers, from venereal taints: and paraphimosis, 
from imprudence in drawing back the prepuce before 
the parts are sufficiently grown. But in the adult, it, 
perhaps, is almost in every case, the effect of vinereal 
disease. 

The treatment is pretty generally the same, as res- 
pects this local affection. If the symptoms run high we 
must bleed, apply leeches to the part, warm fomenta- 
tions; give cooling purges, low diet, mildest drinks: and 
in phymosis, inject milk and water, frequently, into 
the space between the glans penis and prepuce. If the 
disease does not yield to this treatment, the stricture 
must be cut, by slitting it so far as will give freedom to 
34 



266 OF DRUNKENNESS. 

the parts. Nor must this operation be delayed too long, 
or mortification may follow; but this must be left to the 
surgeon if one is to be had; if not, it would be the safest 
after a trial of several hours, or a day or two, of the 
above remedies, to venture to do it with a very sharp 
penknife; this must be entered with its back next the 
glans penis, and the part slit with an outward cut. The 
emollients, &c. must still be continued, till the inflam- 
mation is removed. 

In cases arising from syphilis, it will generally yield 
to a free use of emollients, and the liberal use of mercu- 
rial ointment, but the ointment used for this purpose, 
ought neither to be old nor contain any stimulant article, 
as balsam, honey, turpentine, &c. which are generally 
added to this ointment. Quicksilver and nicest fresh 
lard, should alone compose this ointment. 

SECTION XLVI1I. 

Of Drunkenness, or Self- Debasement. 

This is a disease known in every age, and perhaps, 
in every country. It is one of the evils which mankind 
choose to bring upon themselves; and its most usual cau- 
ses are supposed to be the love of cheerful company; dis- 
tress of mind; want of sense in children, and idiots; lan- 
guor of spirits, or of the corporeal feelings, and neces- 
sity from habits thoughtlessly contracted, which ever 
after render this stimulus necessary. Many circum- 
stances may lead to a man's getting drunk once in his 
life, and for which he may be excused, but drunkenness 
as a habit, is ever bottomed on infidelity. In common 
language we talk of being as drunk as a brute. This 
is a strange abuse of language, and of the brute tribe, 
who in this particular is always man's superiour. I have 
never heard of but one animal being intoxicated, and 
this was a goat who wholly disdained a repetition of it. 

Man alone is capable of transgressing every law, na- 
tural or divine, by boldly turning himself upside down 
to lick up the dust of every vice. He who becomes a 
drunkard, erects a temple to vice, and all the horrid su 



OF DRUNKENNESS. 2QJ 

perstructure rests on infidelity. We are commanded to 
break no law; but lie who wallows in the temple of Bac- 
chus, built by himself, can keep no law. Bacchus ac- 
knowledges no worshippers who do not renounce all other 
gods: at least, while in his presence. Besides, no man 
can worship two masters; he will love one and hate the 
other; and it is especially true with those who love the 
bottle. This is the most unhallowed ground upon which 
man can walk; and the deity has marked every step 
through it with vice in all its most heinous forms; so 
that this crime is seldom found alone; and instead of 
being a cloak or excuse for other offences, it is the cause 
of them; and, therefore, always doubles offence, in- 
stead of lessening it. But, I forbear: it belongs to an- 
other profession to point out its heinous consequences, 
in this world, and more especially in that to come; while 
to punish the offender belongs to the civil law. It is the 
business of the physician, in his usual garb of humanity, 
to overlook the fault, and apply a remedy for the relief 
of suffering man, under all circumstances. 

If you find a man who has been wicked enough, or 
fool enough, to get drunk, or a child unwittingly made 
so, a first consideration in such cases is a free current of 
fresh air; if it is discovered at an early stage, a gentle 
vomit of Avhite vitriol or ipecacuanha may be given; if it 
is far advanced, it will be best to turn the patient on his 
side, or on his belly, that he may be enabled to vomit; 
and the stomach may be left to empty itself; all garters, 
handkerchiefs, and tight clothes, must be loosened; and 
if the patient is very far gone, stimulant injections of salt 
and water should be given. We must never bleed till 
the patient has in good measure recovered, when it may 
possibly be useful in preventing congestions, particular- 
ly in bad habits. It is never necessary, however, to bleed 
largely; on the contrary, such a practice would be dan- 
gerous. But perhaps the only remedy generally neces- 
sary, is throwing cold water on the patient's head until 
he is sobered. I have used this in many cases, and in 
some where the patients were entirely senseless, and it 
has always given speedy relief. I have also seen quar- 
relsome persons when drunk, and about to fight, to get 



868 * OF DRUNKENNESS. 

to a pump, and by letting a good deal of cold water pass 
over the head become much sobered. 

I am much at a loss to account for the manner in 
which cold water acts in these cases. The following 
seems the most satifaetory to my mind: it operates by 
rousing the lungs from a state of torpor, and thus infu- 
ses new vigour into the system by means of oxygen. I 
also imagine, that the prostration from drinking ardent 
spirits is always occasioned by its operating primarily 
on the lungs, impairing their functions; and the brain 
is thereby suddenly subjected to a reduction of stimu- 
lus, for want of oxygen. Hence it would seem to fol- 
low, that the indication of cure is to restore completely 
the process of respiration, and strength and regularity 
of action returns, notwithstanding there may be a con- 
siderable quantity of spirit upon the stomach; and all this 
corresponds with the circumstances and facts in the 
case. 

It has been a prevalent opinion, that persons once in 
this habit cannot leave it off without danger. This is an 
errour; and let no man, surrounded by weeping, or per- 
haps needy friends, weeping over his baseness, console 
himself with the notion that however much he may re- 
pent having formed such a habit, that he no longer has 
it in his power to retract. He should, he must, and may 
safely retract, or else, wo be to the wretch, who, in spite 
of every endearing entreaty, and every caressing invita- 
tion to the contrary, dabbles along until he becomes the 
torment of his friends, the indignant scorn of strangers, 
the crucifier of his own body; until his conscience and 
every faculty of the mind is seared as with a hot iron; 
nor stops the devouring foe till he has destroyed even a 
moral faculty, and leaves the filthy body goaded with 
resolve upon resolves; but fortitude has fled, never to re- 
turn till tea, coffee, bitter infusions, cordial diet, mild 
drinks of small beer, buttermilk, milk and water, and 
active industry, shall wholly change the constitution; 
and this is generally but the work of a few weeks or 
months. 

Let it not be said I colour the picture too high. If you, 
reader, feel in reading as I do in writing, you would 



OF HEADACH. &69 

mgtet with me, that, were it possible to banish drunken- 
ness from the world, it would be worthy martyrdom at 
the stake. If it is not impious thus to speak, what 
praise, what glory would follow the man who would die 
at the stake, to save such a host of sinners! But, thou 
Mightiest, such is not thy righteous providence: thou 
hast infused light into each one, by which he shall walk 
in the light of day, but stumble in the gloomy shades of 
night, and answer, at the mighty day, each one, for 
the dark deeds done in the dark hours of the conscience. 
Let me admonish every one, then, to choose the 
light, burnish bright the conscience — like the brass of 
the helmet, it rusteth, and passeth away — the steady 
practice of virtue shall burnish this faculty of the mind, 
brighter than brass, more durable than gold — and when 
the bells of death shall ring in your ears — its knocker 
strike at your bursting heart, this light shall not be ex- 
tinguished: for the science of alchymy applies alone to the 
mind of man; here lies the philosopher's stone, handled 
skilfully, the conscience, more base than iron, shall wax 
vastly more precious than gold. 

SECTION XLIX. 

Of Headach. 

Headach is generally but a symptom of disease. 
Where it is habitual, which is often the case, it mostly 
arises from gout, or from chronick affections of the sto- 
mach. It would be entirely useless to speak in this 
place of heatlach, as arising from the various diseases 
with which we are afflicted; for in such cases regard 
must be had to the primary symptoms. Headach, how- 
ever, sometimes arises from debauch; from eating too 
much; or from an article happening to disagree with 
the stomach, or from sudden diminution of the secretions. 
In all those cases it will be sufficient to take a little phy- 
sick, a gentle emetick, or cleanse the stomach by drink- 
ing plentifully of chamomile tea; and in healthy, or full 
habits, to lose a little blood. I have been subject to se- 
vere headach; I discovered it arose generally from eat- 



&7Q OF HEADACH. 

ing fresh pork, with turnips or cabbage; by avoiding 
those articles. I have not had it for many months. The 
only speedy remedy which I found for this disorder, 
was a pretty full bleeding. The application of cold 
water or vinegar to the head will sometimes be useful, 
and also bathing the feet in warm water. 

Upon the whole, headach is generally a consequence of 
intemperance, or neglect to observe how each article of 
diet agrees with us; or costiveness; and all those things 
may generally be avoided, and we thereby escape this 
severe pain of the head. 

In nervous headach, which is generally excited by 
something disagreeing with the stomach, an opening in- 
jection, and afterwards taking a few drops of ether, spirit 
hartshorn, compound spirit lavender, or a little elixir vit- 
riol, in a small glass of cold water, will answer: smelling 
at hartshorn, or lavender, will sometimes be useful. But 
even here, if the symptoms tun high, a very mild emet- 
ick, or a small bleeding will answer. In obstinate cases, 
irritation applied to the neck by scratching smartly, or 
applying a blister will be advisable. 

Vertigo, or giddiness, and megrim or a pain over one 
eye, generally accompanied with giddiness, are but vari- 
eties of this disorder, and are excited by the same causes 
as headach, and require a similar treatment: these af- 
fections are most commonly the consequence of irregular- 
ity of the bowels, in the decline of life, and yield best to 
warm purgatives, as tincture rhubarb; heira picra in spi- 
rits; or a little castor oil taken in wine, or a little strong 
toddy; if these do not relieve, we should in all cases, take 
a little blood, and it is a fact that the aged bear small 
bleedings well, and often derive great benefit from this 
remedy in their diseases. In young persons troubled with 
giddiness, purging or bleeding moderately, or a gentle 
emetick, will generally relieve them. They should never 
touch spirituous purgatives. At all periods of life gid- 
diness sometimes arises from fasting; for such cases a 
very little food should be taken, and a little interval left 
before we make a meal, for the stomach beiii^ generally 
debilitated, may easily be injured by taking much food 



OF THE TOOTHACH. 37'i 

before its action is in some measure restored, by means of 
a little mild food; this is infinitely better than a drain, 
which is toe often taken for this purpose. 

SECTION h. 

Of the Toothach. 

Toothach is very often connected with a rheumatick 
diathesis, but it also- arises from caries or rottenness of 
the teeth, and this is probably oftener the consequence of 
some defect in the constitution, than of sweets or the rash 
exposure of the teeth to hot, and cold, articles of drink 
and food. I am inclined to believe, that except from ac- 
tual violence, we seldom injure the enamel of the teeth, 
until the constitution is impaired, by the manifold irregu- 
larities which we practise. Or what is now, perhaps, 
equally common, constitutional debility, which is inher- 
ited. 

It is true that toothach in general, although dependant 
on general disorders, is so locally fixed on the teeth, that 
it is to them alone we can apply a remedy. I have sel- 
dom seen any benefit arise from bleeding, purging, absti- 
nence, &c: toothach sometimes is accompanied with fe- 
ver, catarrh, headach, &c: in such cases bleeding, absti- 
nence, and other remedies, which operate generally on 
the system, may be useful. But where we are not sen- 
sible of other symptoms of disease, we should always 
confine ourselves to local remedies. If the tooth is hol- 
low, a pill of camphor and opium, a little lint moistened 
with oil cinnamon, oil cloves, of peppermint, or a strong 
tincture of the pricklyash berries, will often succeed. If 
it does not, or if the tooth is not carious, a pretty large 
blister applied from behind the ear to a considerable way 
on the under jaw, will seldom fail to remove this painful 
affection. 

The tooth ought now to be plugged with metal, or ir 
want of an artist, gum mastick, white wax, or gum elas- 
tick will answer. Articles applied outwardly as hot as 
they can be borne, are often useful, as scorched tow, or 
a cotton cloth rolled up and held to th? cheek; but moist 



272 OF THE TOOTHACH. 

warm applications ought to be avoided; they certainly 
predispose much to catching cold; in very obstinate ca- 
ses a poultice of mashed potatoes, or a poultice of bread 
and milk, with a little camphor, will give effectual relief, 
if we are careful to avoid catching cold. 

Should all those things fail, the tooth should be 
drawn, for the constant irritation of an aching tooth on 
some constitutions, may be productive of much mischief; 
nor is it apt to leave the temper unruffled. Aqua fortis, 
or oil vitriol, or spirits sea salt, should never be applied 
to the teeth; if a caustick is necessary, burning the part 
with a hot Avire, through a quill to avoid burning the lips, 
will be much safer than those acids, and equally effectual. 
I shall conclude this article by admonishing the reader 
to avoid much scouring of the teeth with tooth powders, 
or filing them. Strict cleanliness is at all times essen- 
tial, and frequent brushing with a soft brush and cold 
water, may be useful. But I have no hesitation in say- 
ing, that attention to such things as improve the gene- 
ral health, as exercise, temperance, &c. are more effec- 
tual in giving health and soundness to the teeth, than 
all the dentists, and dentrijices in the world. Let it not 
be supposed that I wish to throw the least shade of 
censure or disrespect on the useful profession here men- 
tioned. I only mean that by proper attention to such 
means as promote health, we should have less need of 
the dentist. But with respect to dentrijices, 1 am clear- 
ly of opinion, that much injury has been done by an 
abuse of them, as well as by using such as are pernicious 
in themselves. Those who are prejudiced in favour of 
dentrijices will find a good one in the list of medicines. 
For gum biles, the best application is a roasted fig kept 
on the part, till the suppuration is perfected, when it 
must be opened if it does not burst; frequent rinsing of 
the mouth with very weak soda water, or some weak 
bitter infusion will be necessary, and soon restore 
soundness of the part. 



OF EAKACH. 273 

SECTION LI. 

OfEarach. 

Jb&arach often arises from inflammation, from the sud- 
tlcn obstruction of some of the excretious, and sometimes 
from insects getting into the ear. Where there is evi- 
dence of inflammation we should bleed, purge, and en- 
join abstinence, and apply blisters behind the ears; if 
the symptoms progress notwithstanding these remedies, 
we may expect a suppuration, and should apply poul- 
tices of bread and milk over the ear, and syringe the 
part well two or three times a day, with a little warm 
milk and water; and when the abscess breaks, the ear 
should be tied up with a pleget of cotton or tow, and 
frequently syringed with warm soapsuds for a few days; 
afterwards, with chamomile, or sage tea. 

When it arises from taking cold, by which some of 
the excretions are obstructed, a little cooling physick, 
with bathing the feet, and drinking a little warm tea 
going to bed, and stopping the ears with a little wool, 
or cotton, will generally succeed. When it arises from 
insects, which I have seen, we will generally dislodge 
them, if alive, by injecting warm oil, or weak campho- 
rated spirits, into the ear. In all cases of violent pain 
in the ear, we ought carefully to examine the ear in a 
strong light, and always pour oil into the ear. I was 
once applied to for a distracting pain in the ear, in 
which the patient described his distress to be extreme. 
On inspecting the ear, I discovered some fine threads 
therein, this induced me to introduce a probe, and I 
soon entangled a large quantity of spider's web. I now 
threw in an injection, and a pretty large spider came 
rushing out in full vigour; it had been there upwards of 
twenty hours, and was so far entered that I could not 
see it, though I examined in a strong light. 

Another case occurred, in my practice, where one of 
those large black beetles, commonly called clocks, 
which fly about in the evening, darted suddenly into the 
ear of a gentleman. He described his sufferings as h?~ 



374 OF INFLAMMATION OF THE EYES. 

ing extreme: the noise he likened to loud thunder, and 
an indescribable restlessness and horrour, which exist- 
ed, rendered his agony peculiarly great. I drew the 
insect from his ear by means of a flat probe bent at the 
end. Had the accident occurred in his sleep he would 
not have had the least idea of the cause of his distress. 
Let this case be remembered; for, even in this case the 
persons in company could not believe him, until they 
saw the insect actually brought forth. 

SECTION LII. 

Of Inflammation of the Eyes. 

This inflammation may arise from a variety of causes, 
as dust, or small particles of stone, wood, &c. getting 
into one or both of them, from the eye lashes turning in- 
wards, from the hair pushing their roots too far inwards; 
the down from the expanding leaf-buds in spring, and 
riding through the woods where we come in contact 
with spider webs, is a very frequent cause of inflamma- 
tion of the eyes. Acrid fumes of aqua fortis, spirits 
hartshorn, &c. will sometimes inflame the eyes. It is 
sometimes epidemical, and often passes through a whole 
family; most inflammatory diseases inflame the eyes. 
Lues venerea sometimes brings it on in the most aggrava- 
ted form: it is also obvious that it may often be the con- 
sequence of accidents, as the sting of insects, a stroke, 
&c; much straining, or stooping; or improper straining 
of the eyes in viewing the sun, or other luminous bodies, 
or too close looking at candle light, in fine sewing, 
reading, &c. 

In all cases of this affection, it is particularly neces- 
sary to discover its cause, and if possible avoid it, and 
then the disease must in common be treated on general 
principles. Low diet, cooling drinks, avoidance of light 
and dust, or the heat of a fire; and using cooling phy- 
sick, and frequently washing the parts in cold rose water, 
or a weak cold infusion of chamomile, will generally 
succeed. If the case is violent, and does not seem to 
yield speedily to the above treatment, pieces of bread 



OF INFLAMMATION OF THE EYES. $75 

soaked in cool weak lead water; or the pith of sassafras; 
or slippery elm bark, soaked in cool water, may be tried 
for a few days; and blisters applied to the neck, and 
behind the ears. Leeches should always be applied 
freely about the eyes when much inflamed. Should all 
the above remedies fail, we may now consider the in- 
flammation of a chronick nature, and a change must be 
made in the treatment. 

I have found in all cases of inflammation of the eyes, 
where there seemed to be a vibration between acute and 
chronick inflammation, that washes of every kind are 
either useless or hurtful. The best remedies here, are 
the free use of liniment of best oil of almonds and nice 
clear fresh lime water; or the same oil with a very little 
sugar lead in it. In the more inveterate cases, warm 
poultices of bread and milk; or a blister applied imme- 
diately over the eye lids, in conjunction with the lini- 
ment, should be advised. Blisters should never be ap- 
plied over the eye, in recent inflammation: at any rate, 
not till we reduce the patient by bleeding, purging, ab- 
stinence, &c. 

I am well convinced that much mischief is done to the 
eyes, not only by applying eye waters too strong, and 
with saline matters in them that chrystalize, or dry into 
salts; but also by continuing watery moisture of any 
kind too long. Thus, for instance, we make a strong 
wash of sugar lead, of white vitriol, &c. we apply this 
freely to the eyes, the heat dries up or rather evaporates 
the fluids, and leaves the saline matter on the eye, and 
thereby produces much irritation instead of lessening in- 
flammation. I am convinced from experience that whe- 
ther the above explanation be correct or not, vast injury 
is done by washes of sugar lead, and white vitriol, in 
active inflammation of the eyes: and I am certain, the 
practice would be improved if we were to reject those 
things altogether, and substitute in their place, the cold 
mucilage of elm, antl sassafras pith, cold milk and 
water, rose water, or cold infusions of chamomile flowers. 
And in cases somewhat advanced, mild liniments: those 
cases still more chronick, sugar lead, white vitriol, or 
laudanum and water, may be used with good effect. But 



$76 °*" WANT OF APPETITE. 

even here, it is highly probable, brandy, or laudanum di- 
luted according to circumstances, with water, will su- 
percede the necessity of all saline articles, and I most 
seriously recommend to every person, to try those reme- 
dies first: and I hope on trial, it will be found a great 
improvement in ophthalmick inflammation. It remains 
to remind the reader, that in all cases of recent inflam- 
mation of the eyes, the lowest possible diet; cooling 
drinks, pretty free bleeding; and cooling purges, and 
careful avoidance of light, are especially requisite, to se- 
cure the sight. 

SECTION LTII. 

Of icant of Ajrpetite. 

Want of appetite is occasioned by many causes, as 
intemperance in eating and drinking, want of exercise, 
grief, or the pressure of any of the passions on the mind, 
too gross a diet, the immoderate use of tea, coffee, to- 
bacco, or opium, and from constitutional debility. Want 
of appetite attends all febrile diseases, and most others; 
in this condition of the body, appetite is by no means to 
be desired, and therefore what I say respecting appetite, 
is to be understood as relating to persons who are labour- 
ing under no particular disease, and able to attend to 
their business. 

In general, the first and principal means for its remo- 
val, are sufficient exercise, and strict temperance in diet, 
as well as drink; then a close examination of the respec- 
tive articles of our food, and we will often find it 
owing to the use of some article of diet, which disagrees 
with the stomach. We must, in general, avoid grea- 
sy, or sweet articles, warm bread, or cakes containing 
fat, or butter. A spare diet should be used for a few 
days, and if this, with a little cooling physick, does not 
relieve, the elixir vitriol in water will often succeed. 
If the case is obstinate, a gentle vomit will be necessa- 
ry. In languid constitutions, the tincture of bark, with 
a little ether, will succeed admirably. Pleasant bitter 
infusions are t mostly useful. Where it proceeds from 



OF THE HEARTBURN, AND WATERBRASH. %?J 

ilic passions, we must try by all means to avoid their in- 
fluence, by travelling;, keeping company, or application 
to business. 

Upon the whole, they who live temperately, and ex- 
ercise reasonably, will seldom suffer from want of appe- 
tiie; and if nature should languish a little in this respect, 
we need not be over anxious, but leave a little to time 
and abstinence. But there are cases where the stomach 
becomes weak from the use of too poor, or scanty diet; of 
this, persons of common sense can judge best themselves, 
and they will seldom find any thing necessary but a gra- 
dual improvement in their diet; making it reasonably sti- 
mulant, by increasing the quantity of animal food, and 
condiments, as pepper, mustard, &c; and sometimes by 
taking a little good wine, or even brandy. But those 
stimulant articles can never be useful to young persons, 
except for a few days, as medicine, on a debilitated sto- 
mach: their constant use will impair the digestion of 
such people. 

SECTION LIV. 

Of the Heartburn, and Waterbrasli. 

The heartburn is a disease of the stomach, notwith- 
standing the absurdity of its name; and it is generally 
accompanied with waterbrasli; which last, is a iluid col- 
lection upon the stomach somewhat acrid, generally 
acid, sometimes mixed with bile. Heartburn may pro- 
ceed from any thing which impairs the tone of the sto- 
mach; it is sometimes attended with nausea, or vomiting, 
or a considerable flow of watery fluids from the mouth. 
It often attends pregnant women; distress of mind, or 
any thing which debilitates the stomach, or the general 
system, may excite it. In severe cases it will be ne- 
cessary to open the bowels with rhubarb and magnesir:: 
then the use of a little magnesia, or calcined inasine- 
sia, a little milk, Gr milk and lime water, chewing a 
few kernels of peach stones, a little sweet spirit nitre 
in cool water, a few drops of elixir vitriol in water, or 
a little soda dissolved in water, will senerallv succeed: 



OF THE HICKUP. 

but permanent relief is only to be expected from exer- 
cise, and close attention to that kind of food, and drinks, 
which agree best with the patient. 

This disorder is mostly habitual, and a symptom of 
dyspepsia, or chronick debility of the stomach, to which 
I must refer the reader for further instruction. I beg 
leave to admonish every person who values his health, 
or prospects in life, to abstain from spirituous medicines, 
or drams, for this affection of the stomach; they, in ge- 
neral, will eventually do more mischief than the dis- 
ease. It is true, a dram of rum or brandy will for a 
time, force the stomach into action, but at each repeti- 
tion, it loses more and more this effect, till a man may 
drown his stomach in spirits, and obtain no benefit, but 
increasing harm. To persons in the decline of life, they 
are often useful, and mostly safe. 

SECTION LV. 

Of the Hickup. 

Hickup. is mostly a symptom of a disease, and seems 
to be a spasmodick affection of the stomach and dia- 
phram. It arises from various causes, as diseases of 
the stomach, brought on by malignant, or low fevers: 
from poisons; scirrhus; or injuries done some of the 
viscera; it also frequently arises from indigestion, or 
from swallowing much dry food, as crust of bread. We 
should always, if possible, discover the cause, and 
adapt the treatment to the circumstances. Where it 
proceeds from violent disease, in its last stage, it is al- 
ways a dangerous symptom; a little milk and lime water; 
magnesia rubbed in cold water, and a very little cinnamon 
water or oil anise; or a few grains of soda, with a little 
mint, nutmeg, cinnamon; or a little cardamum seed pow- 
dered fine and mixed with cool water. Brandy, or lau- 
danum, should be rubbed over the region of the stomach; 
or mint pounded and laid on. A spoonful of milk will 
sometimes succeed, sweet spirit nitre; or ether, in small 
doses, or a few drops of laudanum, or sometimes a 
glass of very good wine, or wine whey, will succeed^ 



OF CRAMP OF THE STOMACH. $79 

We should apply a blister over the stomach in severe ca- 
ses. Where it arises from overloading the stomach, an 
opening glyster; a few drops of elixir vitriol in water, 
or drinking a glass of cold water, very leisurely, or a 
glass of soda water, will generally succeed. If they do 
not, a gentle vomit, or cathartick, should be taken. 

Where it arises from poisons, or wounds, mild muci- 
laginous drinks should be taken, and such remedies 
used as are suited to expel, or destroy the poison. To 
the mucilaginous drinks in cases of wounds, we should 
add the use of opium or laudanum, and keep down in- 
flammatory symptoms, by bleeding and cooling injec- 
tions. For hickup arising in a healthy stomach, from 
eating dry food, or a little too much common food, a sud- 
den call, or drinking a little cool water very leisurely, 
w r ill generally be sufficient; if not, a pretty full dose of 
magnesia should be taken. I conclude by most solemn- 
ly admonishing every person, to refrain from drams in 
such cases. Unless it be in the decline of life, it will 
invariably lead to mischief. 

SECTION LVI. 

Of Cramp of the Stomach. 

This affection is occasioned by gout, and is apt to 
come on suddenly, attended with much danger: and it 
may arise from irregular gout under appearances of hy- 
pochondriasis, or hystericks; from strong vomits; and a 
slighter kind of it, sometimes attends pregnant women; 
and, it is, also, in some measure habitual in aged per- 
sons, who have been long affected with dyspepsia, or ir- 
regular gout. In all severe cases of cramp in the sto- 
mach, we should give laudanum largely; open the bow- 
els by mild injections; get the patient, as soon as possi- 
ble, into the warm bath. 

If it be from gout of long standing, and more especial- 
ly, if in the decline of life, and in persons accustomed to 
the use of ardent spirits, brandy must be given with free- 
dom; the feet should be bathed in warm water. In fe- 
males who have not been accustomed to ardent spirits, 



£80 OF THE NIGHTMARE^ OR INCUBUS. 

ether in pretty full doses, will he a safer remedy. If it 
arise from pregnancy, the bowels should be opened with 
injections, and a little blood taken; or if the habit is re- 
duced, a few drops of laudanum may he taken; after- 
wards magnesia, or rhubarb, must be used to keep the 
bowels open. 

In persons predisposed to this disease, the occasional 
use of whole mustard seed, will answer a good purpose, 
and if taken going to bed, will lessen the liability to at- 
tacks in the night, its most usual time of attack. Where 
it arises from a strong vomit, at its commencement, it may 
generally be removed by drinking plentifully of warm 
water, and applying hot wet cloths to the stomach, 
bathing the feet, and giving glysters. But if it has pro- 
gressed till the patient is much prostrated, these reme- 
dies would be dangerous; laudanum alone should be 
trusted, and it should be repeated every five or ten min- 
utes, till it answers the purpose. If it is not to be had, 
wine whey, or toddy, should be given, and efforts made 
by purging glysters, to open the bowels, as soon as 
possible; or a few drops of sweet spirit nitre, or com- 
pound spirit lavender, may be given for want of laudanum. 

section lvii. 

Of the Nightmare, or Incubus. 

This disorder attacks persons in their sleep, and in 
its most severe form, distresses with ideas of danger, 
such as imagining they are about to be torn by animals, 
or stabbed, or shot at; about to fall from dangerous preci- 
pices; or bestrode by some vicious creature, which keeps 
us from moving; from these we make desperate efforts 
to escape, by getting away, or by hallowing, or striking, 
&c. The immediate cause of this affection is probably 
some obstruction in the blood, from debility of the heart, 
or other parts concerned in the circulation. And its 
most usual cause is debility, arising from great fatigue, 
or such as is constitutional. 

That overloading the stomach at supper, may occasion 
this disease, I have no doubt, but I am well convinced 



OF THE NIGHTMARE, OR INCUBUS. 281 

an empty stomach is more dangerous to such persons; 
they should by no means overload the stomach, nor 
should they ever retire to bed without some solid food 
upon the stomach. Its cause in most cases is constitu- 
tional debility; and, anxiety or want of exercise, or fa- 
tigue, or intense study, will excite it; so will sleeping 
with the clothes on, especially garters, handkerchiefs, 
&c. It may also arse from indirect debility in full habits. 

Whatever is calculated to invigorate the constitution, 
as temperance, exercise, &c. is calculated to remove this 
disorder. All sensualities, fatigue, &c. must he avoid- 
ed. The cold bath, and the occasional use of prepara- 
tions of iron, bark, and elixir vitriol, will sometimes be 
highly useful. Those of full habits must lose blood, 
and take a little cooling physick. Persons subject to 
this disease should not sleep alone, or at least, they 
should sleep in a room where there is some other per- 
son; and enjoin upon them, in case of moaning or hollow- 
ing, that they shake or call the sufferer, till he answer; 
this may probably sometimes prevent death, in such cases. 

There is a milder form of this disease, in which the 
patient imagines himself to be flying, or jumping, with all 
the sailg-froid of a merry-andrew, over rivers, houses, 
trees, &c. and generally concludes with a self-compli- 
ment for having performed great feats, before admiring 
multitudes. Sometimes, however, he soars too high, 
and the jaunt becomes painful, and terminates in strug- 
gles similar to those of common incubus. Persons long 
subject to nightmare, are generally entirely, conscious of 
their situation, and while they endeavour to rouse abed- 
fellow, who they desire, most anxiously, to shake them, 
they still are unable to stir even a finger; but by great 
exertion they either moan or breathe audably, till they 
recover, or rouse up some person to their relief. 

To conclude, whatever invigorates the constitution is 
the remedy for incubus. But I cannot dismiss this arti- 
cle, without cautioning the reader against a horrid prac- 
tice sometimes recommended: the taking of drams at 
night, in order to prevent it; such a practice may possi- 
bly sometimes keep off this disorder, but in most cases. 
it will bring the devil in its stead. If the stomach re- 
86 



%&% OF SWOONINGS, OR FAINTING. 

quires a late stimulus, take a little whole mustard seed, 
bark, elixir vitriol, or a little well boiled onion, or a pill 
or two of assafcetida and iron filings. 

SECTION LVIII. 

Of Swoonings, or Fainting. 

Fainting appears to be a sudden prostration of the an- 
imal functions, while the vital, though impaired, still 
perform their office. Its causes are various, as loss of 
blood, fright, excessive fatigue, or weakness either di- 
rect, or indirect, long fasting, violent affections of the 
mind, breathing air of crowded places, which has lost a 
part of its oxygen. It also may arise from sudden ex- 
posure to a stove-room, or fire, after having suffered much 
cold. I have seen it brought on, ouce, from swallowing 
a spoonful of hot soup: the person lay in a deep swoon 
for a few minutes; he then arose, and made no further 
complaint. It is often excited from striking the elbow, 
so as to injure the ulnar nerve. 

In all cases of fainting, it is essential, in the first 
place, to give the patient free access to the air; if they 
sink in a crowded room, or a room too warm, they must 
be carefully and speedily removed, cold water, or vine- 
gar and water, may be sprinkled or thrown in the face; 
the body must always he laid straight, and with but a 
very small elevation of the head. If the place is warm, 
fanning will always be necessary; hartshorn, spirit lav- 
ender, or burnt feathers, may be held to the nose. 

If fainting is alarming from its long continuance, we 
should give spirits hartshorn, spirits lavender, or ether; 
or, for want of these, a little wine, or spirit aud water. 
And if it occurs in full habits, we should bleed as soon 
as the patient is somewhat recovered, for fear of conges- 
tion; and it may be well to open the bowels, and avoid 
whatever may have occasioned the fit. Where it pro- 
ceeds from exhaustion, as from hemorrhage, flooding in 
childbed, &c. the patient's safety often depends on the 
strictest quietness: a little exertion, at such a time, may 
destroy life: we should give a little wine, with a few 



OF FLATULENCE, OR WIHDY BOWELS. 283 

drops of laudanum, as soon as possible; and a little salt- 
ed meat, or nice fish, or a little panada, will be advisa- 
ble. We must always bear in mind, that there is much 
danger to be apprehended from stimulating too rapidly; 
therefore, in all cases, we must give our remedies in 
small quantities. Where it arises from sudden distress 
of mind, it will generally be sufficient to rouse the pa- 
tient by volatiles applied to the nose; aud when some- 
what recovered, let the patient drink freely of some mild 
drink, to promote perspiration. 

Persons who have fainted should never be bled with- 
out the the advice of a physician. All such as are lia- 
ble to faint easily, should avoid crowded places, more es- 
pecially in the summer. Let it be remembered, that in 
all cases, we must give the patient free access to fresh 
air, lay the body on the back, and not raise the head too 
much; throw water in the face: the last remedy must not 
be continued long; if it does not succeed, volatiles must 
be used. Many persons have been lost, for want of those 
simple remedies, and more especially, where they have 
been suddenly raised to a sitting posture, by which 
means, the weight of blood is thrown too much upon the 
languid heart, and lungs, and destroys the patient. 

Persons who have fainted, should indulge themselves, 
for a day or two, and live on the lighter kinds of diet; al- 
ways remembering that, where there is much languor, 
from exhaustion, the diet should be cordial, and consist- 
ing pretty much of animal food, if there is no strong con- 
traindi cations, from an inflammatory diathesis, which 
sometimes attends persons labouring under debility. 

To conclude, frequent fainting is an unpleasant and 
dangerous occurrence, and the best advice should be had, 
to discover its cause, and remove that state of the sys- 
tem, which may predispose to it. 

SECTION LIX. 

Of Flatulence, or Windy Bowels. 

This disorder mostly troubles persons who do not use 
sufficient exercise, those who study intensely, or whate- 



284 OF CHILBLAINS AND KIBES. 

ver tends to impair the tone of the stomachy or general 
system. If it arise irom costiveness, a pretty free use 
of magnesia, or mild glysters, will be necessary. We 
must endeavour to use such articles, as agree best with 
the stomach, and in general, it will be found much ve- 
getables cannot be used; potatoes and well boiled on- 
ions, are mostly the best; and the .frequent use of dry 
water biscuit, and a very little salted meat once a day, 
with proper exercise, will he principal remedies towards 
permanent relief. This affection is mostly accompanied 
by acidity, arising from indigestion, which suffers a spe- 
cies of fermentation to take place. As palliatives, the 
following articles will generally answer: take soda half 
a dram, oil anise, or peppermint five drops, rub this a 
little, and add ten table spoonfuls of cold water; of this 
a table spoonful may be taken occasionally. Or, take 
maguesia two drams, and treat it in the same manner; 
of this a table spoonful will be a dose, and if too thick 
for some persons to swallow, a little more water may be 
added. A little strong ginger tea, a tea spoonful or 
more of ether, or sweet spirits of nitre, and in some ca- 
ses laudanum, will give relief. The use of the iron pill, 
which will be found in the list of medicines, or the elixir 
vitriol in water, or tincture of bark, with ether will be 
excellent remedies. 

Lastly, avoid drams; they may spur up your stomach, 
but soon lose their effect, and never fail to impair the 
tone of the stomach of young people. The aged will 
often find relief in those cases, from taking tincture rhu- 
barb, or heira picra, dissolved in good old whiSkey or 
spirit. 

SECTION LX. 

Of Chilblains and Kibes. I 

There appears to be some ambiguity in the applica- 
tion of these arbitrary terms. I shall speak first of kibes, 
as a disease of the heels; it proceeds, perhaps, in all cases 
from exposure to frost, or mucb wet applied to the feet; 
snow water in particular. It is a painful affection of 



©F CHILBLAINS AND KIBES. 285 

the heels, but, something similar occurs about the toes, 
in some cases: the symptoms are swelling, intolerable 
itching, small whey coloured blisters, crackings of the 
skin, like cuts: it occurs in winter, and is most trouble- 
some when the patient becomes warm. Apply equal 
parts sweet oil and spirits turpentine, two or three times 
a day, and wear a plaster of some mild ointment, and 
in general, such persons, even children, ought to wear 
boots in time of snow, or wet weather, and these should 
be well oiled or waxed. Roasted turnips are sometimes 
applied, they may be useful in cases which have been 
suffered to run on till there is high inflammation, but 
they should never be applied in recent cases. Vinegar 
containing a considerable quantity of sugar lead, is a 
good remedy: a liniment of lime water and sweet oil, 
will sometimes succeed. 

Chilblains maybe excited in the same way as kibes. 
by dabbling with the hands in hot water, or too much 
handling of snow, or snow water, and also by slight frost 
bites. But I suspect, this is often a humour connected 
with some constitutional defection, and is somewhat sim- 
ilar to ringworm, and humours which occur about the 
jverinceum. Chilblains is a violent itching and cracking 
of the skin of the palm of the hands, in particular, or on 
the fingers, or other parts, these dry up now and then; 
a new itching comes on after an uncertain interval, and 
is soon followed by whey coloured blisters, cracks in the 
skin, &c. 

The same remedies may be applied here, as directed 
for kibes, particularly a very strong wash of sugar lead 
and vinegar, or a weak solution of arsenick may be used: 
frequent washings w T ith castile soap and water; or lime 
water and sweet oil, may be applied. But persons af- 
fected with chilblains should take a little cooling pby- 
sick, particularly cremor tartar with a great deal of mu- 
cilage now and then, and perhaps that of the slippery 
elm is best; nice gum arabick, or other mucilage, may, 
however, be used. The diet must be temperate, and the 
drinks of the mildest kinds, as milk and water, butter- 
milk, infusions of burdock, sarsaparilla, or sassafras, 
but these should be very weak, and taken when cold. 



386 OF HERPES IN GENERAL. 

SECTION LXI. 

Of Herpes in general. 

There is a grea^ variety of this affection of the skin: 
I shall mention a few necessary distinctions. 

1. Herpes simplex, a dry mealy eruption, which af- 
fects various parts of the body, sometimes confined to 
the knees, or face, &c. 

S. Herpes miliaria, or ringworm, mostly on the face. 

3. Herpes zoster, or shingles, encircling the body. 

All these appear to be but varieties of the same dis- 
ease. Where they have become habitual, it is useless 
to apply outward remedies; here mild diet consisting of 
a good deal of milk; taking occasionally a little cooling 
physick, as cremor tartar, alone, or mixed with sulphur 
or magnesia; the use of mucilaginous drinks, and fre- 
quently washing the parts affected with mild soap and 
water, and after drying the part well, it may be dusted 
with prepared chalk, starch, flowers of sulphur, or pe- 
rnvian bark. 

A course of mucilage of slippery elm water, and small 
doses of Fowlers solution, may be safely tried, but the 
arsenick must not be continued long at a time; two or 
three weeks, in small doses will be sufficient at one term, 
but it will often be necessary to repeat. 

The ringworm may, however, generally be removed 
by outward applications: a strong solution of sugar lead 
in vinegar; rubbing with green walnuts, or an ointment 
of white precipitate. Sometimes a liniment of sweet oil 
and sugar lead will answer, or a very weak ointment of 
corrosive sublimate, or a solution of corrosive sublimate 
in lime w T ater, or a blister applied over the part. 

4. Herpes syphiliticus, or venereal eruptions. 

5. Herpes pustulosus, or the milk crusts of infants, 
the scaldhead, and other ulcerous affections of the skin. 

For the treatment of syphilitick herpes, the reader is 
referred to the article on syphilis; for that of milk crust, 
to the diseases of children; it remains, then, to say some- 
thing respecting scaldhead. 



OF SCALDHEAD, OR TINEA CAPITIS. £87 



SECTION LXII. 

Of Scaldhead, or Tinea Capitis. 

This is a dreadful scabbing and ulceration of the 
head, mostly in children, and is mostly the consequence 
of filthiness, or gross feeding. To the unpleasant symp- 
toms of violent itching, scabs, and ulcers, is soon added 
an abundance of lice; these, with the matting of the hair, 
render the disease as disgusting to the sight, as dread- 
fully tormenting to the patient. If this disease is early 
attended to, a few careful washings with soapsuds, twice 
a day, and, after drying the part, applying a pretty 
strong ointment of red or white precipitate, or of tobac- 
co, with a few purges, and mild diet will seldom fail 
to arrest it. 

If it has progressed, we must proceed with caution; 
the bowels should be opened, the hair cut away, or care- 
fully shaved off; the head well washed twice a day with 
soap and water, and a poultice of carrots and yeast ap- 
plied for a few days; then the head may be dusted with 
well powdered fresh charcoal, and this succeeded in a 
few days with sprinklings of bark, at first, containing a 
little powdered savin leaves, never, however, forgetting 
to continue the washing, nor to give cremor tartar, or 
magnesia, with mucilage, so as to keep the bowels well 
open. In violent, neglected cases, we should- commence 
the washings with milk and water, for a day or two, and 
must never, if the weather is cool, neglect to keep a warm 
cap on the head, after removing the carrot poultice. 
The lice will cause much irritation, and must carefully 
be sought after and removed. 

Almost instant death has followed the rash application 
of tobacco, and other violent things, to the head exten- 
sively ulcerated and inflamed. And in other cases, dan- 
gerous diseases of the eyes, ears, and general disease, 
as fever, and even dropsy of the brain. I have always 
found the course above laid down to be successful and 
perfectly safe. If there should be a translation of this 
disease, we must give a little brisk physick. as jalap and 



£88 OF PIMPLES IN THE FACE. OF THE ITCH, 

calomel, bleed according to circumstances, as fever or 
pain require, and apply blisters on the neck; and if there 
is much apparent danger, warm fomentations, and an 
onion poultice may be applied, or linseed meal may be 
made into a poultice and applied. 

SECTION LXIII. 

Of Pimjjles in the Face. 

These need no description, but are sometimes very 
troublesome. Persons much troubled with these pimples 
should avoid too much singing, stooping, exposure to 
the heat of a fire or stove; all spirituous drinks, as well 
as fermented liquors, are to be avoided, and much ani- 
mal food. They should live on a diet consisting a good 
deal of milk and vegetables, and drink nothing hut cool 
water, milk and water, buttermilk, or vinegar and wa- 
ter. A little cremor tartar, and flowers sulphur, or mag- 
nesia, should be taken, to keep the bowels open, aud a 
free use, now and then, of mucilage of slippery elm will 
be found useful; afterwards the pimples may be rubbed 
with flower of sulphur in the evening, and washed off 
in the morning; or rubbing them with sweet cream, and 
washing off with c as tile soap and water; or wash the face 
with sour buttermilk, or a decoction of sour dock; but 
these must he applied cool. 

SECTION LXIV. 

Of the Itch. 

The itch is most generally the companion of those who 
live uncleanly, but by contact with the matter of it, it 
sometimes invades the most cleanly families, affecting 
all its members before they are aware of its nature. 
This eruption is found particularly about the fingers, 
elbows, hams, but in tender skins it rapidly spreads over 
the whole body; and I have even seen it in infants, not 
only excessively tormenting, but really dangerous. It 
may be known by its regularity of appearance; while 



. I OF THE ITCH. 28Q 

other eruptions change colour frequently, this goes on 
slowly, and regularly to increase, and it is in the even- 
ings when Ave undress, that it is particularly trouble 
some. The little watery pimples which appear about, 
and particularly between the fingers, and which contain 
a thin fluid, may be considered as sufficient evidence of 
itch. 

Philosophers have amused us with their speculations 
about animalcule, resembling ticks, turtle, &c. I shall 
not stop to acknowledge or deny those notions, for if it 
be caused by animals of diminutive size, I am sure they 
are vicious little gluttons; and as they prey on our living 
bodies, we should destroy them wherever we find them. 
This I know to be true of itch, that dirty families can 
seldom be free from it, and I strongly suspect, clean- 
liness alone would eventually banish it from society. 

The most speedy and effectual remedy for itch, is 
flowers sulphur mixed with lard, and rubbed on the 
parts affected, every evening. A strong ointment of white 
precipitate, is a very good application for this affection of 
the skin. Or an ointment of red precipitate, or of white 
hellebore, or a weak wash of oil vitriol in water. Wash- 
ing the parts with soap and water, and after drying, rub- 
bing with dry flowers of sulphur, or starch containing a 
little very fine powdered white hellebore. In inveterate 
cases it may be necessary to take a little flower sulphur 
and cremor tartar, so as to keep the bowels open, and use 
a course of the mucilage of elm. 

Lastly, bed clothes, apparel, and in short, every arti- 
cle of the household must be perfectly cleaned, and kept 
so, or you can never banish this disease of the skin for 
any length of time. In delicate persons it will be safest 
not to rub too much of the body at once, but go over it 
gradually with the ointment. Quicksilver ointment is a 
dangerous, unnecessary, and very often an ineffectual re- 
medy, and ought never to be used by persons exposed 
to the weather. Nor should persons exposed to the wea- 
ther use the other ointments too freely: I have seen a 
case of severe salivation, from the use of the red precipi- 
tate ointment, applied on account of itch. 
, 3? • 



£90 OF PRICKLIHEAT. OP YELLOW MORPHEW, &C. 



SECTION LXV. 

Of Prickliheat. 

Prickliheat bears some resemblance to itch, but is 
more fiery coloured when the body is warm, and almost 
disappears when the skin is cool; not much about the 
lingers, and more equally distributed over the body than 
itch. Its usual causes are, uncleanness of the skin, sur- 
feits in eating and drinking, too much acidity on the sto- 
mach, and sudden exposure to extremes of temperature. 
Use mucilaginous drinks with cremor tartar and sul- 
phur; or magnesia and rhubarb. A tepid bath, and fre- 
quent changes of linen, or flannel next the skin, and 
avoiding all irregularities will be necessary. 

SECTION LXVI. 

Of the Yellow Morphew, or Morphcea Icteroides. 

This disease of the skin principally affects persons of 
delicate constitution. It generally begins about the breast 
and neck, and from thence spreading very slowly over 
the whole body, gives the skin the appearance of deep 
sun freckles; but wherever it appears the scarfskin is 
raised, and may be easily rubbed off, leaving a red spot; 
upon this the same yellow scarfskiu soon appears again. 
Sometimes it appears in the face, but this is very rare. 

From its long continuance, it no doubt has some con- 
nexion with some visceral disorder, and this I suspect 
is always the liver; no discolouration is seen in the eyes, 
and so far as my information goes it is not dangerous. It 
very probably is more owing to slight debility in the 
functions of the liver, than to any real disease in that or- 
gan. Sulphur, applied in ointment, will remove it spee- 
dily, but it returns, and probably nothing but remedies 
which operate on the whole system, so as to give tone 
and vigour, will remove it, such as reasonably good liv- 
ing, with constant exercise, and perhaps, the occasion- 
al use of tonicks, and of mucilaginous drinks. Cleanli- 



OF THE LEPROSY. 291 

ness is essential, but T suspect bathing is generally im- 
proper for such persons, for there is an openness of the 
skin which causes it to absorb water. This I suspect from 
the following circumstance: I have been affected with 
this eruption for many years, and ever since, if I go in- 
to the water but a few minutes, my skin feels teuse and 
unpleasant, and gives considerable impediment to walk- 
ing for some time after it, and if I remain for more than 
a few minutes in, I become enfeebled, and sickness at 
stomach, and sometimes very severe vomiting succeeds. 
I have been less sensible of these symptoms from the 
cold bath. Such persons should wear flannel at all 
times, and in the winter, two ply of flannel should be 
worn, for they are predisposed from this openness of the 
skin, to pulmonary affections, and suffer particularly from 
cold moisture, or even duckings from rain. 

SECTION LXVII. 

Of the Leprosy. 

This disease does not often appear in this country, 
but instances do sometimes occur. It is a great, scourge 
to the eastern nations, but I suspect it is mostly the off- 
spring of uncleanness. The disease is known by a very 
extraordinary thickening of the skin, cracks, welts, dry 
prominences, with a whitisli scurf constantly forming, a 
weeping which issues from these cracks. The whole ap- 
pearance of the skin at some distance, is something like 
a light mouse or lead colour. But there is nothing more 
characteristick of this disease, than the thickening of the 
skin. I have seen but one case of it, the subject was a 
Frenchman, a young mechanick who had just made a 
trip to Orleans, from the Ohio, and came by the way of 
one of our seaports. During this long journey, he was sub- 
jected to a great variety of water, and no doubt was not 
sufficiently cleanly in changing his linen, &c. Immedi- 
ately after his return, he was attacked with a bilious re- 
mitting fever, then prevalent, and with it came the lepro- 
sy. He was the patient of a physician of great experi- 
ence, who politely asked me to see the case with him; 



$92 OF WORMS. 

every endeavour was made to relieve him, his fever was 
subdued, but the prostration was too great for him to 
contend with this horrible leprosy; and after suffering 
a few weeks he died. 

I do not feel competent to lay down the best treatment 
for tuis disease, at any rate advice should be taken. I 
will, however, state, here, as my opinion, that the utmost 
cleanliness and frequent washing with mild soap and 
water, with the liberal use of mucilaginous drinks, mild 
tonicks and diaphoreticks, as sweet spirits of nitre taken 
two or three times a dav, and succeeded with cold infu- 
sions of bark, snakeroot, or contrayerva, are among the 
principal remedies. 

SECTION LXVIII. 

Of Worms. 

I beg leave, in the first place, to observe that this is 
the hobby of quacks, old women, and mothers. What 
cramming and stuffing have I seen practised on poor lit- 
tle children, suffering under diseases/ sometimes no 
doubt, in cases in which worms had no concern. Even 
agues, inflammatory fevers, &c. must be treated as though 
every child was likely to be eaten up with these worms. 
And it is a fact as strange as it is true, that many, very 
many mothers are to be found, who will cram their chil- 
dren, and by force too, with pink root tea, garlick boil- 
ed in milk, worm seed and its oil, soot, rue, &c. that will 
turn their faces against every thing which they call doc- 
tor stuff; should it even be a few grains of ipecacuanha 
or prepared chalk, unless you assure them it is for the 
worms. Thus, if a child have a bad breath, it is worms: 
if it grind its teeth in sleep, it is worms: if it eat too 
much, or if it has little appetite, it is worms: if its upper 
lip swells, it is worms: if it start in sleep, has a purging 
whether sick or well, it is worms. In short, such is the 
ridiculous infatuation of people* about worms, that few 
children are safe, even under the care of the most skil- 
ful physician, for in almost every family, they will give 
what they consider vermifuges, by which the stomach 



op wok ms. 29-3 

and bowels are rendered weak and irritable, or fever, or 
inflammatory affections of the viscera, the head. <S:c. are 
so much aggravated, that no skill can avail. Reader! 
ak without prejudice, for I have no favourite no- 
tions to offer, but I have beheld such wicked and prosti- 
tuted exercise of parental authority, that my heart bleeds 
for the poor little sufferers, who smart under the ignorant 
regimen, of worm mothers* and worm doctors. I will 
answer for it, if your child is full of worms, it is your 
own fault: give children such diet as they ought to have; 
keep them clean, and let them exercise freely, and you 
may ipare your trouble, and much risk to your chil- 
dren. , 

If a child is labouring under a pleurisy, or inflamma- 
tion of the head, or if inflammation exists about the liver, 
bowels, &c. what greater risk could you expose your 
child to, thau to give it strong pink root tea, oil 
wormseed, and such like heating articles; thousands of 
children are thus detsroyed. I would admonish every 
head of a family, that thev should never °:ive worm 
medicine without good advice, when their children are 
sick, and most sacredly follow directions: when they are 
well it is not often needed. 

The only certain sign of worms is their appearing in 
the stools, or being vomited up, md it must be admitted 
that they sometimes produce disease, both in children 
and adults, particularly the tape worm. The following 
are the most common kinds which are found, 

1. The teres, or common round worm, resembling the 
earth worm. 

2. ilscarides. or small thread like worms, particular- 
ly troublesome about the rectum. 

3. Tcenia. or tapeworm: there are many others found 
in the human intestines, but they are rare, and will yield 
to such remedies as are proper for the expulsion of the 
three kinds enumerated. Where advice is not to be had, 
the following symptoms maybe considered pretty strong 
evidence of Avorms: a su&len swelling of the upper lip, 
provided the subject is not scrofulous, frequent pains and 
uneasiness in the bowels without fever, irregular appe- 
tite. If these or other symptoms leave strong grounds 



£94 OF A STRANGURY. 

for believing worms are present, a purge of jalap and cal- 
omel may be given, provided the patient is not labour- 
ing under a low state of disease ; this will generally dis- 
lodge more or less of them, and we may now venture, 
provided no inflammatory disease forbids, to give oil 
wormseed, powder of tin, pink root, rue, garlick, or a lit- 
tle salt water, always remembering to work those articles 
off, with castor oil, or jalap and cremor tartar. More 
than one or two doses of calomel should not be given, in 
those cases. 

Those habitually troubled with worms, should take 
pills composed of equal parts of tin powdered, and assa- 
foetida, made into pills. Or any other tonicks, as bark, 
bitters, iron filings, elixir vitriol, &c. They should 
avoid unripe trash of fruit, or green herbs: and live on 
solid wholesome food, and for a time, delicate children, 
or perhaps others, will be benefited from an occasional 
glass of good old wine: exercise and sound nourishing 
food, in small quantities, are the best preventives. 

The ascarides are sometimes excessively troublesome 
on account of the itching, they produce about the seat, 
and as they are situated so low down, are more difficult 
to dislodge by medicines. Glysters alone will remove 
them speedily: glysters containing a good deal of salt 
will sometimes succeed, or two or three table spoonfuls 
of sweet oil, and a few drops of oil wormseed, in the 
usual quantity of water: or a little aloes ground in water, 
or lime water, or a strong decoction of wormseed. 

SECTION LXIX. 

Of a Strangury. 

A strangury or difficulty of passing urine, proceeds 
from various causes, as stone or gravel, from injuries 
done the abdomen, from diseases, the application of blis- 
ters, &c. In all cases we should open the bowels with 
emollient glysters, give mucilaginous drinks; and now 
and then, a tea spoonful of sweet spirit nitre. If these 
da not succeed, we must have recourse to the warm bath, 
or bleeding; according to circumstances. In reduced 
patients where much pain accompanies this affection, we 



OF ISCHURIA. — OF ENEURESIS, &C. 295 

must give laudanum. In general, the use of linseed or 
parsley tea, with sweet spirit nitre, will relieve. 



SECTION LXX. 

, Of Ischuria. 

Ischuria is a term which seems to have a much more 
extensive application than that of Strang ur. It is ap- 
plied to obstructions of urine from every cause, as dis- 
eases of the kidneys, ureters, bladder or strictures of 
the urethra. In all cases of ischuria, we must careful- 
ly ascertain, whether the disorder be a detention merely, 
as in strangury, or whether the kidneys have ceased to 
perform their functions. By feeling gently on the low- 
er part of the belly, we may feel the bladder full and 
tense, and the presure gives the patient pain: here, it 
would be improper to give the patient diureticlc drinks; 
we must either bleed, give emollient glysters, apply warm 
fomentations, or the warm bath, according to circum- 
stances; and, if these do not succeed, a catheter must be 
introduced, and when the water is drawn off, gentle 
purges, and mucilaginous drinks, and sweet spirit nitre 
may be given; and in aged persons, a very free use of 
horseradish is necessary. If there is no urine found in 
the bladder from pressure, we must give mucilaginous 
drinks, mild glysters and purges. When it proceeds 
from diseases, as inflammation of the kidneys, or ureters, 
or bladder, or the stone, &c. the reader is referred to the 
treatment in such cases. 

SECTION LXXI. 

Of Eneuresis, or a Habit of wetting the Bed. 

This disagreeable habit is sometimes found in grown 
persons, and there is some probability of its arising from 
neglecting to correct children for this practice. But 
while I give it as my opinion that this habit is often es- 
tablished by neglect, I have no doubt but it is often a 
disorder, over which the person affected has no control, 



&96 OF DISEASES OF THE ORGANS OF SENSE. 

and therefore measures for correction should never be 
extended to cruelty. We are assured by Cullen, that 
blistering the perincenum has often succeeded in remo- 
ving this disorder. I would recommend it to be tried, 
in preference to the many ridiculous articles which have 
been used: but I think it highly probable that the tinc- 
ture cantharides would answer our wishes. 



SECTION LXXII. 

Of Diseases of the Organs of Sense. 

SUBSECTION I. 

Gutta Serena* 

Is a deprivation of sight, without any very evident 
defect of the eye. It is a loss of nervous power, and 
most generally an incurable disease. Sometimes, how- 
ever, it may be removed where it proceeds from inflam- 
mation, or from congestions, or what is called humours 
about the eye. It sometimes proceeds from a hardening 
or wasting of the optick nerve: all such cases are hope- 
less. But as the most skilful cannot judge of this in the 
living eye, and as this disorder has sometimes been cured, 
we should in all cases indulge hope, and use our best en- 
deavours, particularly at an early stage; and as diseases 
of the eye are only to be distinguished by skilful occu- 
lists, the earliest opportunity should be taken to consult 
a person who is competent, otherwise we may easily do 
ourselves irreparable mischief. 

There never can be any necessity for persons prescrib- 
ing for themselves, in cases of gutta serena, but it may 
save them from imposing quacks, &c. to describe the 
disease, and point out some principal remedies. There 
is a glassy, dead-like appearance of the eye, the pupils 
mostly considerably enlarged, but after the disease is 
confirmed, it is sometimes very small. If the eye is held 
shut some time, and then opened in a strong light, no 
change occurs in the pupil; whereas, in an eye where 
the nerve is sound, it dilates while the eye is shut and 



OF A CATARACT. £97 

dark, and contracts rapidly when the light is admitted 
to the eye again. 

In the early stage of this disease mercurial purges; 
blisters to the neck; and, in full habits, bleeding from the 
arm, and leeches applied about the temples. When it 
is more confirmed, a salivation, a seton in the neck, ce- 
phalick snuff, with a, little calomel added to it. Take 
white hellebore in fine powder half a dram, sage or 
other green leaves well dried two drams, calomel half a 
dram; rub these fine, and use frequently as snuff. In 
some cases gutta serena is accompanied with constitu- 
tional debility, and with scrofula, which would render 
it unsafe to give strong purges, or to salivate. In those 
cases we should use the seton, the cephalick snuff, and 
tonicks, as bark; iron, with the gums; and if no strong 
symptoms of scrofula are present, calomel in small doses, 
combined with tonicks. In all cases of gutta serena, 
we should use electricity, or rather galvanism, as soon 
as the more inflammatory symptoms are removed. And 
in cases accompanied with scrofula, the extract of hem- 
lock should be given, accompanied with occasional mild 
purges, in full habits; and with tonicks, where there is 
much debility. 

subsection 2. 

Of a Cataract. 

In cataract the optick nerve remains healthy, but vision 
is lost in consequence of the chrystaline lens turning 
white, or clouded, so as to prevent the rays of light from 
reaching the retina or optick nerve, at the bottom of the 
eye. When confirmed, it gives something like the ap- 
pearance of a speck upon the eye to the unskilful. If the 
eye is held shut, and then opened before a strong light, 
the pupil contracts rapidly before the light. Such peo- 
ple can always distinguish day from night. 

No outward applications can be of any use in these 

cases, and they have often done much mischief. In the 

early stage, we should use the same remedies as for 

gutta serena, but when the disease is confirmed, nothing 

38 



§98 OF A STRABISMUS — OF SPECKS OR FILMS. 

but an operation affords the least hope. I have known 
instances of severe applications being made, under an 
idea of specks on the eye, when it was a cataract, entire- 
ly out of the reach of all such remedies. In all diseases 
of the eyes, it is particularly necessary to get good ad- 
vice, early. Diseases of this organ, require prompt and 
powerful treatment, and a little errour may be destruc- 
tive to vision. 

subsection 3. 

Of a Strabismus, or Squinting. 

This affection of the eyes is too well known to require 
any description. It is generally occasioned by expos- 
ing children to the light in such a manner, as to let it 
shine into one eye only; often it proceeds from imitation, 
therefore, nurses who squint, may excite this unpleasant 
disorder among young children. When it is early at- 
tended to, weaving goggles which oblige the child to look 
straight forwards, will often remove squinting: it must 
be obvious, such children should be removed from per- 
sons of this habit. 

subsection 4. 

Of Specks or Films upon the Eyes. 

These are generally the consequence of violent inflam- 
mations, and often succeed smallpox, the measles, inju- 
ries done the eye, &c. I suspect most of them proceed 
from neglect, or improperly treated inflammation. In 
recent cases, while active inflammation continues, we 
should by no means use vitriol, white sugar, alum, and 
many other things of this kind, which are often recom- 
mended; they are always attended with danger, and oc- 
casion total blindness in some cases. Instead of these 
violent articles, two or three brisk mercurial purges; 
blisters to the ears, and neck; and a liniment of best oil 
almonds and fresh clear lime water, are the best rem- 
edies. 



OP THE BLOOD SHOT EYE WATERY EYE, &C. S99 

If the case is confirmed, and inflammation removed, 
benefit may sometimes be derived from using strong vi- 
triol water, made by dissolving white vitriol in water; 
or, a little alum and white sugar, rubbed till you cannot 
feel their particles, may be blown into the eye. These 
are always very doubtful, and I have never seen any ad- 
vantage from them, in my own practice. Nor have I 
ever failed in cases proceeding from common inflamma- 
tion, in arresting these specks at an early stage, by purges, 
blisters, free use of warm milk and water, and the lime 
water liniment. See the article, Inflammation of the 
Eyes. 

SUBSECTION 5. 

Of the Blood-Shot Eye. 

This is occasioned by many causes, as strokes upon 
the eye, straining in vomiting, coughing, and often from 
intemperance in drinking. If pain and inflammation fol- 
low, we must have recourse to such remedies as are re- 
commended for inflammation of the eyes, from other 
causes. Washing the eye with cold mucilage of elm, 
will often succeed, if not, we should apply leeches: take 
a little cooling physick, live low, and if these do not suc- 
ceed, we should use brandy, beginning with it consider- 
ably reduced, and gradually augmenting the strength 
till it answers the purpose, or till we use tlie strongest 
brandy without dilution. 

subsection 6. 

Of the Watery, or Weeding Eye. 

This is generally owing to neglect or badly treated 
inflammation; sometimes it proceeds from relaxation, and 
debility of the vessels of the eye, and this from scrofula 
or other constitutional debility. Sometimes it is owing 
to an obstruction of the lachrymal duct, by which thft 
tears that are constantly forming to moisten the eye, (and 
then pass into the nose,) are thrown out upon the cheek, 



BOO OF DEAFNESS. 

The use of general strengthening remedies, and temper- 
ance, avoiding much candle light sewing, or reading; 
with frequently washing the part with brandy, or a very 
clean filtered infusion of bark. When it proceeds from 
an obstruction of the lachrymal duct, nothing can be of 
the least service but an operation, by which we restore 
the passage for the tears into the nose, this obstruction is 
called fistula lachrymalis. 

subsection 7- 
Of Deafness. 

The ear is liable to many accidents, which interrupt 
its functions, or impair or destroy iis structure. Dis- 
eases, catching cold, wounds; too much or hardened 
wax; too much moisture; or malconformation of the ear 
may occasion deafness. When it proceeds from disease, 
we must in general keep our views upon the disease, and 
leave the symptom of deafness to nature. But if it re- 
mains after the disease is removed, or when it proceeds 
from an unknown cause, by examining the ear, we will 
often find it choaked up with wax; too dry, or weeping 
out a thin fluid. In all those cases the treatment may be 
nearly the same, and must be very simple. Syringe the 
ear frequently with milk and water, or mild soapsuds; 
stop the ears with wool, or cotton, and drop a few drops 
of oil almonds, or nice sweet oil into the affected ear, ev- 
ery night. Blisters should be applied, and repeated, but 
I most seriously caution every person not to tamper with 
the inside of the ear; its structure is delicate, and easily 
injured, therefore, the best advice should be taken. We 
are told by the celebrated Cheselden, that a gentleman 
in England had four children born deaf, he was advised 
to apply blisters to the ears of his future children. He 
did so, and three were born and thus treated, and all had 
their hearing. Does this not leave a hope that congeni- 
tal deafness, if early discovered, might be removed by 
blisters, electricity, or other remedies, under the direc- 
tion of a skilful physician. 



OF DEAFNESS. 301 

What a lamentable fact it is, that we have no schools 
for the dumb in this country! How has it happened 
that no good heart, in devising and executing plans, for 
the comfort of their fellow creatures, or honour of their 
country, should not have chosen this humane and neces- 
sary measure, for the vast number of dumb persons, 
which are in a good measure useless to themselves and 
to society; and indeed, often rendered vicious from ill 
treatment, or for want of understanding those around 
them! If some humane person, or persons, were to set 
about this great work, by raising a small fund, some 
gentleman of talent might soon be got to teach such a 
school, and scholars no doubt would soon accumulate., 
After the success of Mr. Braidwood, and since at Lon- 
don, it really is surprising no such schools have been 
attempted in this country, at least none within my know- 
ledge. I recollect reading somewhere, an interesting 
account of a young gentleman who was sent from New- 
York, to Mr. Braidwood's school in Edinburgh, which 
I consider one of the most agreeable narrations upon 
earth. 

Let a fond parent imagine their unfortunate child, sul- 
len, stupid, vicious, or rash and awkward: who like the 
animals around him has no movements of the sweet little 
tattler, to express his wants, his thankfulness to his pa- 
rents, nor of knowing, and acknowledging the goodness 
of Him who made us, as sent to a school where he shall 
not only learn to read and write, but speak in daylight, 
with fluency; and what greater source of pleasure, praise, 
and gratitude could they find. 

Would it not be worth your while to rest upon a pil- 
low of straw, and live on bread and water, to obtain 
such a gift for your unfortunate child! But more espe- 
cially, would it not be worth the attention of every cler- 
gyman, and every society, to endeavour to found schools 
for such persons, and make them free to the poor, and 
even maintain such as require it? Surely, if the Lord 
repays gifts given to the poor, this must be one which 
will never reap less than "thirty, sixty, or an hundred 
fold" 



302 LOSS OF THE TASTE — OF THE LOSS OF SMELL. 

It is with peculiar gratification I mention, that, since 
the first edition of this work, a school has been estab- 
lished at Hartford, in Connecticut; on a very extensive 
plan, by which, it is hoped all the dumb persons of the 
whole nation may be accommodated, for a considerable 
time to come. 

SUBSECTION 8. 

Loss of the Taste 

Is generally the consequence of some disease, but no 
doubt this sense is often impaired by intemperance, and 
tooliigh seasoned food. We must endeavour to find out 
the cause, and avoid it if possible. If this defect exists 
in weakly habits, or is accompanied with palsy, we must 
use such remedies as are calculated to invigorate the 
constitution; apply gentle galvanick shocks; or simply 
chewing horseradish and beets, alternately, will probably 
often have a good effect, for, galvanick piles, of weak 
powers may be made of these roots; or you may gargle 
the mouth with a decoction of seneka snakeroot. In 
cases where an inflammatory state of the mouth, or gen- 
eral system exists, we must pursue an opposite course, 
such as sipping frequently mucilaginous drinks; taking 
a little cooling physick, and if much foulness of the 
mouth, or nausea are present, we should give a gentle 
emetick, and use a mild vegetable diet. In all cases it 
will be essentially necessary, to keep the mouth perfect- 
ly clean, by frequently gargling with mild stimulant gar- 
gles in cases of low action, and in the inflammatory, with 
milk and water. 

subsection 9. 

Of the Loss of Smell. 

This sense is often destroyed by the use of tobacco: 
or inflammation, suppuration; or by the nervous power 
being impaired or destroyed, or suspended by jwlypus 
in the nose. In general, it will be best to content our- 



OF LOSS OF THE SENSE OF TOUCH. 303 

». in this disorder, with frequent washing, by means 
syringe, or snuffing up the no^e milk and water, or 
mild soapsuds: and attending particularly to the general 
health. In polypus, a surgical operation alone, can re- 
move either the polypus, or restore the smell. Stimu- 
lants, as different kinds of cephaliclc snuff, or pungent 
articles, may sometimes be useful, but there never need 
be any particular hurry in those cases, and therefore ad- 
vice should be had. 

SUBSECTION 10. 

Of Loss of the Sense of Touch. 

This perhaps is always a symptom of palsy, and there- 
lore, is to be treated on general principles, as laid down 
for that disease. There is. however, a morbid acuteness 
of this sense dependant on irritation, applied to some 
part of the body, particularly the stomach, as in hypo- 
chondriacks; this too, must be treated on general princi- 
ples, as laid down for hypochondriasis. The cold bath, 
or tepid bath, according to circumstances, will be neces- 
sary in most cases. 



OF HABITUAL DISEASES. 



I AM now about to enter upon a set of diseases, which 
are known to lurk in the body, and are easily excited, by 
a variety of causes, into activity for a time, till having 
expended their force, the patient gradually returns again 
to his usual health, and this in many cases, is very per- 
fect until some little accident, or irregularity lets it loose 
upon the system again. Or such as having s;rown out 
of some epidemick, or fortuitous disease, continues with 
more or less violence to distress during life, as scirrhous. 
cancer, and other diseases. 

I shall commence my observations on habitual, or 
chrouick diseases, with gout, and treat of its varieties, 
as legitimate gout, irregular gout, and chronick rheu- 
matism. . 

SECTION I. SUBSECTION 1. 

Of a Legitimate Gout. 

I believe a true or legitimate gout is mostly heredi- 
tary, or occasioned by the intemperate use of ardent spi- 
rits, and perhaps, more frequently by the immoderate 
use of wine, and malt liquors, together with want of ex- 
ercise. But in those strougly predisposed to gout, the 
most trifling causes may excite it. Such as fatigue, idle- 
ness, a full meal, catching a slight cold, or it may be ex- 
cited by disease, intense thinking, and many other causes, 
so that persons subject to gout, or who have reason to 
expect it, from their ancestors having been severely affect- 
ed with it, must use the utmost circumspection, to guard 
against this most cruel foe. The attacks of the gout are 
supposed to be most usual in the spring, or beginning of 
winter. 



OF A LEGITIMATE GOUT. 305 

As there is a great similitude between the grade of dis- 
en^es of the United States, and those of Sydenham's 
lime in England, I have copied his description of the 
gout. He says, "this distemper comes towards tlie lat- 
ter end of January, or the beginning of February, and 
begins commonly about two in the morning, with a pain 
in the great toe, but sometimes in the heel, the ankle, or 
the calf of the leg; immediately a chilness, shivering, 
and slight fevers succeed, the pain increases gradually 
every hour, and chilness and shivering abate in propor- 
tion as the pain becomes more severe, which at length 
comes to its height towards night, sometimes resembling 
a violent tension, sometimes the gnawing of a dog, and 
sometimes a weight and constrictiou of the parts affected, 
which becomes so exquisitely painful, that the patient 
cannot bear the weight of the clothes upon it, nor the 
shaking of the room from a person's walking briskly 
therein. The pain does not abate till two or three the next 
morning, that is twenty-four hours from the beginning of 
the fit, when the patient being in a breathing sweat, falls 
asleep, and at waking finds the pain much abated, and 
the part affected newly swelled. A slight pain is felt 
next day, and sometimes the two or three following days, 
which increases towards night, and remits towards break 
of day. In a few days it seizes the other foot inihe 
same manner, and after attacking both feet, the subse- 
quent fits prove irregular both with respect to the time 
of seizure and their duration; and what we term a fit of 
the gout is made up of a number of these small fits, and 
goes off sooner or later, according to the age of the pa- 
tient. Thus, for instance, in strong constitutions, and 
such as seldom have the gout, the fit often goes off in a 
fortnight; but in the aged, and those who have frequent 
returns of the disease, it lasts two months; and in such 
as are more debilitated, either with age or the long con- 
tinuance of the distemper, the fit does not go off till the 
summer advances, which drives it away. 

"During the first fortnight the urine is high coloured, 

and lets fall a red gravelly sediment, and the patient is 

usually costive. A loss of appetite, and a chilness of 

the whole body towards evening, accompanying the fit 

39 



306 OF A LEGITIMATE GOUT. 

throughout; and when it is going off, a violent itching 
seizes the affected foot between the toes, and afterwards 
the skin of it peels off by scales. 

"In this state of the distemper the pain only affects the 
foot; but when the gout is exasperated, either by wrong 
management or long continuance, so that the substance 
of the body is in a manner changed into gouty matter, 
it then seizes the hands, wrists, elbows, knees, and other 
parts; sometimes rendering one or more fingers crooked, 
by degrees destroying their motion, and forming at length 
stony concretions in the ligameuts of the joints like 
chalk, or crab's eyes. Sometimes it occasions a whitish 
swelling upon the elbow, almost as large as an egs^ 9 
which gradually grows red. Sometimes it seizes the 
thigh, which seems to sustain a great weight, yet without 
much pain, and thence gaining the knee, attacks that 
part more violently, and the limbs are now so contracted 
and disabled that the patient halts with pain. The 
urine resembles that which is voided in a diabetes, and 
the back and other parts itch much towards bedtime. 

"After many severe fits, the subsequent fits are less 
painful, nature being partly oppressed by the large quan- 
tity of peccant matter, and partly by old age; but instead 
of the usual outward pain, the patient is seized with a 
sickness at stomach, pain in the belly, spontaneous las- 
situde, and sometimes a tendency towards a looseness* 
Upon the return of the pain into the joints the symptoms 
go off, and the pain and sickness coming thus by turns, 
prolong the ^it considerably. In many persons the gout 
breeds the stone in the kidneys. It seldom attacks wo- 
men, and only the aged of this sex, and those of a mas- 
culine habit of body. Children and young persons rare- 
ly have it." 

It may be remarked of the above description of gout, 
that it does not very generally assume all those terrible 
symptoms in the United States. This is, perhaps, ow- 
ing to so few families having, for a succession of several 
ages, pursued such habits of high living, and inactivity, 
as in England. And also, to the great improvement 
in the treatment of our acute diseases. I am decidedly 
of opinion, a true gout is always an inflammatory dis- 



OF A LEGITIMATE GOUT. 307 

ease, and as much under the control of the skilful phy- 
sician, as any other, provided the patients will live as he- 
come them in the intervals. That it is a curable dis- 
ease, I infer from the circumstance, that many have been 
cured by misfortunes which obliged them to labour for 
a subsistence; and others, almost in the twinkling of an 
eye, from fright. 

Unfortunately for mankind, theories or notions of this 
disease gained such firm ground, during the mistaken 
ideas of concoction, an undue reliance on the anima me- 
dica of Stahl, or the vires naturce medicatrices of Cul- 
len, that they still chain down the practice in this dis- 
ease with despotick sway. Thus, we are gravely told 
by Buchan, that it would be as prudent to stop the small- 
pox from rising, and to drive them into the blood, as to 
attempt to repel the gouty matter, after it has been 
thrown upon the extremities. In the first place I an- 
swer to this, that there is no similitude between 
smallpox and gout. The first is a violent acute disease, 
wherein the system has to undergo a thorough change, 
which shall secure it in future from similar disease du- 
ring life; while the latter is a mere chronick predisposi- 
tion, capable always of restraint, and sometimes to spee- 
dy removal, even in its paroxisms, or fits. 

Again. What a pretty out was made of smallpox be- 
fore the time of Sydenham, in consequence of these no- 
tions of concoction, and assisting nature to throw off the 
offending matter! By unduly stimulating the body, the 
whole mass, solids and fluids, were assimilated to the 
nature of smallpox matter, so far as a living system 
could sustain it. And are we not to look for a similar 
result from neglected, or improperly treated gout, which 
always has a tendency to assimilate the body to its own 
nature, or more correctly speaking, fills the body with 
congestions, which, like a stock in trade, or the exer- 
cise of the mind, accumulates in proportion to the ca- 
pital? 

Moreover, when the discerning genius of the great Sy- 
denham discovered the errours in smallpox, and boldly 
pronounced, that we not only must refrain from pushing 
on nature's apparent efforts, in driving out the matter up- 



308 OF A LEGITIMATE GOUT. 

on the skin, but that we could not trust her without ac- 
tual opposition, the whole faculty was alarmed. Thus, 
nature raised a fever, Sydenham endeavoured to lower 
it, the skin was warm, this invited the pustules, he ap- 
plied cool air, gave cool drinks, &c. to oppose the ex- 
travagant efforts of nature. And what was* said? almost 
the whole world rose up at this supposed daring resist- 
ance to the anima medica, or healing powers of nature. 
But happily the improvement in the practice was self- 
evident, and irresistibly gained ground, slowly, spite of 
all opposition. We cannot hope for so easy a conquest 
in the treatment of gout; but I feel sanguine in the be- 
lief, that mankind will eventually perceive, not only the 
folly of grounding our hopes in the healing power of na- 
ture, but discover also, that most of the terrible ravages 
of gout, are owing to wrong treatment, and more espe- 
cially to viewing it as operating some friendly change 
upon the system. 

It is a furious despotick disease, and one unworthy 
the courtship of the meanest reptile. A man who nur- 
ses the gout under an idea of its improving his system, 
and prolonging his life, is like one who having lost all 
hope of pardon from heaven, sells himself to the devil, 
as was the case with Judas Iscariot. The result will 
always be similar, and instead of finding rest, they 
plunge into greater misery. 

And, while the people of Lancaster shire, elephantise 
themselves, by wearing monstrous legs made of wool, to 
keep off this disease,* the aborigines of our countrywalk 
the snowy forest with a thin mockasin, nor dream they 
of gout. Let proper remedies be used, both in and out 
of fits of the gout, and we need not be afraid to immerse 
the tortured foot in cold water. 

I am not singular in the opinion that gout is curable, 
and ought never to be invited or nursed: the illustrious 
Rush, gave rise to the views I have of this disease, and 
I believe with him, it is a general disease, accompanied 
with local inflammation, of a high grade; and which may 
often be subdued by the usual remedies, for inflammato- 

*See Buchan on Gout. 



OF A LEGITIMATE GOUT. 309 

ry diseases. It behooves all mankind to live temperate- 
ly, and actively, but to those who are predisposed to 
gout, from gouty ancestors, it is absolutely necessary, 
otherwise the disease will come on at some period of 
life. A legitimate gout, generally comes on iu the spring 
or fall, therefore, it behooves them to be doubly circum- 
spect at those seasons, regulating their affairs according 
to circumstances. Those of weakly frail habits, are by 
no means to live low; they should live reasonably well, 
and take as much exercise as possible; and on feeling 
any indisposition, in the usual time of the appearance of 
gout, a luild purge of sulphur, or rhubarb and magnesia, 
may be taken. Those of full habits are to live temper- 
ately; milk and vegetables should compose the principal 
part of their diet. 

If gout comes on with many or all the symptoms 
laid down by Sydenham, we should attack it at once 
with spirit: we are to abstract blood from the arm, ac- 
cording to circumstances, give purges every day in ac- 
tive cases of sulphur, combined with cremor tartar, or 
rhubarb; and if nausea, or indigestion are manifested, 
by wind or acid eructations, we should give gentle 
vomits: after carrying these to a reasonable extent, 
we may safely venture to apply cold water, or cold mo- 
lasses to the part affected, but in general, it will be suM- 
cient to expose the part freely and uncovered, to the 
cool air. These remedies in first attacks of gout, ac- 
companied with rest, low diet, and mild cooling drinks, 
and, perhaps, pleasant bitter infusions will be the best, 
will generally completely banish it from the system, till 
it is recalled by some irregularity; and with this great 
advantage over suffering nature, to work off the disease, 
that no congestions are left, which terminate in chalky 
stones in various parts of the body. These concretions 
in the kidneys, liver and joints, from gout, are the con- 
sequence of inflammatory action, unwisely left to vitiate 
the whole system, and assimilate all its parts, to this 
morbid condition. And this is precisely similar, to wa- 
tery congestions in the head, from neglected or wrong 
treated inflammation of this part of the body. 



310 OF VIBRATING GOUT. OF IRREGULAR GOUT. 

SUBSECTION 8. 

Of Vibrating Gout. 

There is a vibrating state of gout, occasioned some- 
times by the great force of the disease, which soon pros- 
trates the system; but, perhaps, more frequently, it is 
occasioned by suffering the disease to expend itself se- 
veral times unopposed. This is a critical state of the 
system, and calls for the utmost skill to adapt suitable 
remedies, but in general, we must be governed by symp- 
toms. If there be violent pain in the feet, or joints, we 
must bleed and purge moderately; if the disease shifts its 
ground, and attacks the stomach or liver, we are to ap- 
prehend the disease has lost its inflammatory grade, and 
we must now test the system with laudanum: if it allays 
the pain, and no fever, nor other unfavourable symptoms 
occur, we may proceed to give laudanum in small doses, 
with mild tonicks; and particularly iron filings, and plea- 
sant bitters: and it may be well to apply blisters to the 
feet, or at least keep them warm, not fearing to bathe 
them in tepid, or cold water, according to circumstances. 
I shall now pass on to giye some account of irregular 
gout, and conclude with some general observations. 

SECTION III. SUBSECTION 1. 

Of Irregular, or Illegitimate Gout. 

I do not intend, under this head, to speak of that vi- 
brating sfate of gout, which has just been mentioned, nor 
of the low grade of gouty diseases, usually acknowledg- 
ed as such, but to speak of such as are either not gener- 
ally known, or acknowledged to be of a gouty nature. 
This is departing, in some measure, from the usual ap- 
plication of the names applied to this disease; but on 
much reflection, I consider the application of these terms, 
which I have chosen, calculated to lead to important 
truths, which are not generally known, or received. 
Among these cases of misplaced gout, we may notice the 



OF IRREGULAR GOUT. -311 

cephalalgia spasmodica, or the sick or habitual headach. 
This often exists at an early period of life, and as it pro- 
gresses, is mostly conjoined with dyspepsia. It is a state 
of gout of much less force, than the arthritis podagra, 
or gout of the feet; and I think the most local, or fixed, 
of any other variety of this disease. It is known by its 
periodical returns; but these periods are uncertain in du- 
ration, being governed much by the conduct of the sub- 
ject. Violent passions, want of regular sleep, excess in 
eating, taking cold, and many other causes may excite it. 
A violent headach of several hours, or even days contin- 
uance, low spirits, loss of appetite, nausea, and in some 
cases, especially after repeated attacks, severe vomiting 
attends, sometimes great intolerance to noise. In those 
whose constitutions are not particularly broken down, 
bleeding is a safe and certain remedy, and it ought iu 
general to be checked by a single bleeding; that is, if the 
patient, in the intervals, is in good health, me may draw 
blood till some symptoms of faintness are produced, and 
if the patient is difficultly affected in that way, he should 
be desired to stand up while the blood flows; but we ought 
never to bleed very largely, we should rather endeavour 
to bleed suddenly, by means of a large orifice. If any 
remains are left of the disease, a purge or two of castor 
oil, senna and manna, &c. should be given. 

If the case becomes protracted, or where the disease 
exists in very weakly habits, or where dyspepsia is ra- 
ther the most distressing, we should give a gentle erne- 
tick of ipecacuanha or white vitriol, and follow it up 
with purges of rhubarb and magnesia, or sulphur and cre- 
mor tartar. In cases still more reduced, we should emp- 
ty the stomach by the free use of chamomile, or carduus 
tea: open the bowels with mild glysters, and give lauda- 
num in small doses, frequently repeated. But I have sel- 
dom seen this disease, where it would not only be safe, 
but really necessary, to take a little blood, and if it is 
.succeeded by small doses of laudanum, it can scarely 
ever be wrong. In the intervals, persons liable to this 
variety of gout must pay a scrupulous regard to regulari- 
ty; but it is seldom, if ever necessary, for them to live 
very low; iu general, a diet somewhat generous is best, 



312 OF GOUT IN THE KIDNEYS, &C. 

consisting a good deal of the lighter kind of animal food: 
fat meats and windy vegetables are to be avoided; and if 
spirituous drink is ever allowable, it must be used very 
sparingly. Much malt liquors, or cider, are improper; 
the best porter is, however, often one of the best drinks; 
nor need such persons, in general, be afraid of a glass of 
pure old wine; but unless it be really such, it ought never 
to be used. It is essentially uecessary for those subject 
to gout in the head, to avoid intense study, troubles of 
the mind, costiveness, and loss of sleep. They should 
never encounter fatigue, but reasonable and constant ex- 
ercise must be unceasingly pursued. 

SUBSECTION 2. 

Of Gout in the Kidneys. 

Nephralgia, or pain in tlie kidneys, without fever, is 
also, sometimes, a misplaced gout; and whether accom- 
panied with calculi or not, in its height, is an inflamma- 
tory state of disease, and requiring the use of the lancet, 
mucilaginous drinks, the free use of magnesia, and mild 
injections; and after the reasonable use of those remedies, 
small repeated doses of laudanum; and a common dia- 
chylon plaster, worn for some time, will be advisable. 
A milk diet, and the occasional use of lime water, will 
be useful in this affection of the kidneys. 

SUBSECTION 3. 

Of Gouty Gonorrhoea. 

Gonorrhoea spuria, or laxorum, a disease resem- 
bling gonorrhoea from impure coition, is also a gouty af- 
fection, requiring remedies which operate generally on 
the system. The same may very often be said of the 
fluor albas of women. In both these cases mild injec- 
tions, first of milk and water, or mild mucilage: and these 
succeeded by weak solutions of lead, or peruvian bark 
filtered through paper: in some cases of gouty gonor- 
rhoea, injections of nice sallad oil, with a few drops of 
laudanum, will be found an excellent remedy. 



OF GOUT IN THE TESTES. AND IN THE HIP. 313 
SUBSCETION 4. 

Of Gout in the Testes, 

A sudden and excruciating pain of the testes without 
swelling, or any venereal complaint, is also, sometimes, 
a symptom of gout; it is apt to alternate with slight gou- 
ty affections of the stomach. This pain is so severe 
sometimes, as to prostrate the patient very rapidly, and 
the part affected continues painful for a day, or more, and 
then leaves the part extremely sore. Large doses of 
ether, combined with repeated small doses of laudanum, 
will generally answer; and after a few r doses have been 
given, pouring ether upon the part affected, and suffer- 
ing it to evaporate, will be useful: the bowels should be 
opened with mild laxatives, and mild glysters given. 

SUBSECTION 5. 

Of Gout in the Hip. 

There is a most obstinate and severe pain in the hip, 
which sometimes lasts several weeks or months, in spite 
of all remedies: there is neither swelling, nor does the 
part ever suppurate, although the hip joint is sometimes 
crippled. This form of gout is found, according to my 
observations, mostly in females, and seems to bear a near 
similitude to gout in the feet of men. I have never been 
able to arrest this disease until it has continued several 
weeks, and sometimes several months. A salivation in 
one instance had no sensible effect, the pain continued 
during the height of it: this remedy does, however, suc- 
ceed sometimes, after the disease has in some measure 
expended its force. Perpetual blisters have little effect. 
I am inclined to believe we should bleed largely, at the 
commencement of this affection, and follow it up with 
large doses of ether and laudanum; and now and then 
give tincture cantharides, so as to excite strangury. 

A pain of an obstinate nature, but not very acute, ac- 
companied with some fever, nausea or vomiting, and cos- 
40 



314b OF THE DIFFERENT GRADES OF GOUT. 

tiveness, but more especially a discharge of bile, green 
as grass, or rather resembling the verdigrise green, is 
ajso a gouty affection, and most usually found in the fe- 
male. Mercury, and gentle emeticks, are the principal 
remedies in these cases; but it is slow to yield to any 
treatment. It will seldom bear stimulants, or even to- 
nicks, till the system is reduced by bleeding and purg- 
ing, which is generally necessary in those cases. 

In short, every part of the body is invaded by this 
disease, and in all cases where sudden pain occurs, 
which does not yield speedily to depletion, or anodynes, 
and especially if disposed to recur, now and then, wheth- 
er it be in the same -part of the body, or sometimes in 
one part, and then another, or whether accompanied with 
fever or not, we are to view it as gout, and treat it on 
general principles. 

subsection 6. 

Of the different Grades of Gout. 

I shall here endeavour to lay down a scale of gout, 
which applies to the regular as well as the irregular gout, 
by which, I think, we may in general, with tolerable 
certainty, determine the grade or inflammatory condition 
present: they appear to be 

1. Gout of the lower extremities. 

2. Of the head, in form of habitual headach. 

3. Of the hip, resembling rheumatism, and to be met 
with, principally in females, or weakly habits. 

4. Diffused throughout the body, in the joints resem- 
bling chronick rheumatism. 

5. In the kidneys, liver; and in the lungs, in form of 
asthma. 

6. In the lungs, in the form of angina pectoris. 

7- In the urethra, vagina; in the skin, resembling le- 
prosy, and various eruptions. 

8. In the stomach, and intestines; this is the lowest 
grade, and seldom appears till the constitution has been 
debilitated by gout in some other part of the body. If 



OF THE DIFFERENT GRADES OF GOUT. 315 

there be exceptions to this remark, it is in cases of ob- 
stinate dyspepsia. 

What has been termed flying gout, will be found 
more or less inflammatory, as it preponderates to either 
extreme of this scale. Each case of misplaced gout calls 
for some little variety in the treatment, locally considered, 
but gout is always to be treated on general principles, 
both as regards medicine and regimen. And I feel con- 
fident that, by bearing in mind the foregoing scale, we 
will seldom be wrong. It follows that in gout of the 
stomach, or intestines, we are to stimulate rapidly, and 
largely; large doses of ether; laudanum; tincture gua- 
iacum; tincture assafcetida in spirit wine, with equal 
quantities of ether, are good remedies; the juice of gar- 
lick or rue, and especially wine, or even brandy, in large 
quantities, in some cases, is indispensably necessary. 

There is still one variety of gout to mention, I have 
seen two cases of it. This form of the disease, is a 
strange mixture of angina pectoris, and hysterical symp- 
toms; or rather, it resembles the symptoms of both those 
diseases at the same time, and as the case is more or less 
inflammatory, partakes more or less of the one or the 
other; those resembling angina pectoris, being most in- 
flammatory. It is accompanied with a strange condition 
of the arterial system, which is a most powerful and con- 
vulsive force in the pulse; this extraordinary action of the 
arteries extends throughout the system, and continues in 
considerable force during the intermissions, remissions, or 
intervals of the other symptoms. The larger arteries 
cannot be compressed, such is their tension: the blood is 
sizey, and the abstraction of blood generally gives tem- 
porary relief. But blood-letting in this disease, like in 
consumption, is but a palliative, and the cure depends on 
the use of the most powerful tonicks, as iron filings with 
assafoetida; bark; and the acetate lead; arsenick, &c. 
but those mineral tonicks ought not to be given without 
good advice. In the paroxysms incredible quantities of 
ether, tincture assafcetida, garlick, and rue juice, are 
necessary; a saturated tincture of camphor is also useful. 

Of all the forms of misplaced gout, that of the intes- 
tines is most difficultly known. It occurs mostly in the 



316 GENERAL OBSERVATIONS ON GOUT. 

decline of life, and often hurries away its victims, in a 
few hours, or a day or two. Persons who are subject to 
indigestion, to asthma, to chronick rheumatism, or gout 
in other parts of the body, are admonished to be on their 
guard against this insidious disease; and wo be to those, 
who in the decline of life, should view this as a salutary 
effort of nature, to throw off disease, and suffer it to run 
on. Persons who have reason to apprehend a looseness 
or other affection of the bowels, is of a gouty nature, 
should take glysters containing full doses of laudanum; 
small doses of laudanum and ether, should be taken by 
the mouth; warm wine, toddy, or brandy, according to 
circumstances; an anodyne plaster should be applied 
over the abdomen, and in obstinate cases sinapisms to 
the feet. When convalescent, especial care must be 
used to avoid catching cold, by keeping the feet warm, 
wearing flannel, and dressing warm. A mild nutritious 
diet should be used, of light animal food, and warm 
drinks, slightly cordial, as warm wine whey, snakeroot 
tea, warm toddy, milk toddy, or milk and water with a 
little ginger. 

subsection 7. 

General Observations on Gout. 

I come now to make a few general observations. It 
has been alleged by the great Cullen, that wherever 
bleeding was proper, opium was inadmissible; this no 
doubt is strictly true as respects acute diseases, but I be- 
lieve the reverse is nearer the truth in chronick diseases, 
and particularly so, in gout and chronick rheumatism. 
We may generally with perfect safety bleed, and purge, 
in those diseases, provided we follow it up immediately 
with anodynes. It has been held as ridiculous, or even 
dangerous by some physicians, to pull down with one 
hand, while we build up with the other, as they express 
it. This language is somewhat imposing, but crouches 
before a scrutinizing examination: and facts will be al- 
ways found to support this contrary position, that where 
we deplete, and succeed it immediately with stimulants, 



(SENERAL OBSERVATIONS ON GOUT. 317 

and particularly opium, or mercury, the abstraction of 
blood will reduce excitement, and leave the excitability 
not accumulated as some would have it, but much more 
susceptible of being acted upon. This increased suscep- 
tibility, is disposed to take on new impressions, and ac- 
tion, or a condition follows, which is characterized by 
the new stimulus. Thus if we remove a part of peccant 
stimulus, by abstracting blood, and give a dose of laud- 
anum, a new and more healthy condition is induced, and 
this position is supported by facts; and we can bleed 
in gout, or chronick rheumatism, or the diseases of the 
aged generally, with perfect safety, if inflammatory symp- 
toms are present, provided we follow it with opiates; and 
these should mostly be # conjoined with sweet spirits of 
nitre, which will determine slightly to the skin, and to 
the kidneys. I consider this an important fact, not gen- 
erally known; and applicable to consumption, and most 
chronick diseases. 

It must be acknowledged that gout is often so firmly 
seated from constitutional predisposition inherited, or ac- 
quired; or the system may be so completely gouty con- 
ditioned, that it is not to be removed, nor even rashly 
treated. But such a condition of the system is, most 
generally, the cousequence of wrong management in its 
first fits. To illustrate and maintain this opinion, let us 
examine but a single series of gouty fits. It commences 
with fever, and violent pain in the lower extremities; and 
it has been remarked, that the duration and violence of 
the gout, is mostly in proportion to the severity of the 
fever. And are we not to infer from the periodical in- 
crease of pain, that fever continues; the state of the pulse 
generally indicates it. Now, what are we to expect from 
this fever; does it make any particular deposition upon 
the feet, and thereby renovate the system? It may be 
answered without hesitation, that it does not; on the con- 
trary, congestions are formed in other joints, in the liver, 
in the kidneys; and I have no doubt, in .the urinary blad- 
der also. Then why are we to let this fever expend its 
unfriendly force on the body? Fever, from whatever 
cause, is unfriendly; and if inflammatory, will always 
form congestions in some part of the body, if we do not 
remove the fever. 



318 GENERAL OBSERVATIONS ON GOUT. 

Facts warrant the assertion, that in proportion to the 
continuance of this fever, so will be the increase of the 
gouty diathesis in future, for it will assimilate the system, 
more and more, to the gouty condition. It is true, na- 
ture eventually wears off the fever; this she is enabled 
to do, by the patient's lessening the usual stimuli, as that 
from exercise of the mind and body; change in diet, and 
drinks, &c. and thus by this weak^ but gradual abstrac- 
tion, the fever and pain is carried off. This in general 
could be more safely and effectually accomplished, in a 
few days by suitable remedies, than in so many weeks, 
or even months, in some cases, by the natural operations 
of the body. 

Let not the intemperate or idje gouty cripple imagine, 
nature will remove the consequences of his own, or his 
ancestors artificial diseases; if we expect nature to cure 
our diseases, we must live agreeably to her dictates, but 
so long as we trample on her laws by intemperance, she 
will mock us to scorn: and while she wrings the de- 
bauchee by the great toe, &c. she would scare him from 
his follv, but not cure his disease. 

How long are we to talk of nature's curing our dis- 
eases, which are. wholly artificial? Is it not one of na- 
ture's most invariable laws to lead us to death; and there 
is no period of life exempt from it, why are we not rather 
to suppose it one of her leading aims, to carry us to the 
grave. 

To conclude, disease is ever a war upon animation, 
and we are to endeavour to remove it under all circum- 
stances. If we are often disappointed, we are still to 
suppose that the physician, who has to trust his patients 
to nature, and endeavour to cure them by earjiectation, 
has gained but a slight knowledge of his profession. 

Lastly, in all forms of gout, most reliance is to be placed 
on activity, and regularity in every thing appertaining 
to our condition. Those of gross full habits, or subject 
to regular gout, must live low, particularly, a inilk diet; 
those subject to the vibrating, or misplaced gout, must 
be less abstemious, but strict temperance is always ne- 
cessary, and while ever the gouty subject can walk, he 
should walk, and even labour constant! v. 



OF CHRONTCK RHEUMATISM. 31Q 

Chronick rheumatism, asthma, angina pectoris, gravel, 
dyspepsia, and goutier, are satellites revolving around 
gout, as their sun or centre; and although some of them 
are remote, still their motions are excited and maintained 
by this gouty centre. I shall, therefore, briefly treat of 
those diseases, in the order in which they have been enu- 
merated. This brings me, first, according to promise, at 
the commencement of gout, to treat on chronick rheu- 
matism. 

SECTION III. 

Of Chronicle Rheumatism. 

Chronick rheumatism is seldom attended with fever, 
or swelling, or evident inflammation. Persons in the de- 
cline of life are most subject to this kind of rheumatism, 
and in general it is fixed to some particular part, as one 
or more of the joints, the back, loins, and shoulder blade, 
&c. It is remarkable of rheumatism, that persons affect- 
ed with it, are highly sensible to the changes of weather; 
and like the barometer, are sensible of changes, before 
they are perceptible by persons in general. It is also 
notable of rheumatism, that it is most troublesome at 
night, and not apt to suppurate. There is a kind of ve- 
nereal rheumatism, attended with painful suppurations. 
These are often taken for mercurial sores; but I suspect 
they are always scrofulous. The disease under consid- 
eration, appears to be continued by a predisposition to 
taking cold, whereby inflammatory .action of a peculiar 
kind, is excited; and therefore, we' are to pay especial 
regard to our dress. I think, in general, the diet should 
be reasonable and not too low: it is not reasonable to 
suppose that a disease, which yields most generally to 
stimulants, should require a low diet. But such person* 
must avoid ardent spirits, and gross animal food, or too 
much fats. When the disease is present, the diet must 
be low, consisting of milk, and mild vegetables: and the 
drinks should be mild and cool. Small bleedings, and 
frequent purging with sulphur, and where this will not 
operate sufficiently, castor oil, or rhubarb, or jalap, should, 



320 OF THE ASTHMA. 

be given to carry it through the bowels. A decoction of 
seneka snakeroot, will be often found useful, and after 
the inflammatory symptoms are somewhat abated, tinc- 
ture guaiacum, or powder of bark, which will be found 
in the list of medicines; or powders of snakeroot cam- 
phor and nitre. This may be made by mixing one dram 
of snakeroot in powder, (no matter which kind) camphor 
half a dram, nitre one dram, grind these fine, and make 
four or six powders, according to circumstances, one of 
which may be taken morning, and evening, drinking a 
cup of whey after it. An infusion of prickley-ash and 
pine knot shavings, is a good remedy; or a table spoon- 
ful of whole mustard seed; if of the dark seed a little 
less will do. The limb pained may be rubbed with 
opodeldock, volatile liniment; or a blister laid on till it 
merely inflames the skin; or a poultice of mustard, may 
be applied, till it becomes painful: but, in general, we 
should reduce the system a little, before we stimulate 
outwardly: I have seen rheumatism translated in good 
measure to the skin, by such applications, and the skin 
became intolerably painful, and sore to the touch. It 
will always require a discriminating judgment, to adopt 
suitable remedies to this disease: I shall conclude this 
article by observing, that the cold bath, purging with 
sulphur, and the plentiful use of whey, are the principal 
remedies for rheumatism; and warm clothing, and exer- 
cise are indispensable. 

SECTION IV. 

Of the Asthma. 

I shall copy this article principally from Buchan: his 
ideas of a spasmodick asthma, without any marks by 
which it is to be distinguished, I shall omit, for, I con- 
fess I know of no difference in asthma, except that of its 
being of more or less force or violence. I shall also 
take occasion to suggest a few remedies, which have been 
particularly useful in my own practice. "Asthma is a 
disease of the lungs, which seldom admits of a cure. 
Persons in the decline of life are most liable to it. It 



OF THE ASTHMA. 3Si 

is distinguished into the moist and dry, or humoral 
and nervous. The former is attended with expectora- 
tion or spitting; but in the latter, the patient seldom spits, 
unless sometimes a little tough phlegm by the mere force 
of coughing. 

"Causes. — The asthma is sometimes hereditary. It 
may likewise proceed from bad conformation of the 
breast; the fumes of metals or minerals taken into the 
lungs: violent exercise, especially running; the obstruc- 
tion of customary evacuations, as the menses, hemorrhoids, 
&c. the sudden retrocession of the gout, or striking in of 
eruptious, as smallpox, measles, &c. violent passions of 
the mind, as sudden fear or surprise. In a word, the 
disease may proceed from any cause that either impedes 
the circulation of the blood through the lungs, or pre- 
vents their being duly expanded by the air. 

"Symptoms. — An asthma is known by a quick labori- 
ous breathing, which is generally performed with a kind 
of wheezing noise. Sometimes the difficulty of breath- 
ing is so great, that the patient is obliged to keep in an 
erect posture, otherwise, he is in danger of being suffo- 
cated. A fit or paroxysm of the asthma, generally hap- 
pens after a person has been exposed to cold easterly 
winds, or has been abroad in thick foggy weather, or has 
got wet, or continued long in a damp place under ground, 
or has taken some food which the stomach could not di- 
gest, as pastries, toasted cheese, or the like. 

"The paroxysm is commonly ushered in with listless- 
ness, want of sleep, hoarseness, a cough, belching of 
wind, a sense of heaviness about the breast, a difficulty 
of breathing. To these succeed heat, fever, pain of the 
head, sickness and nausea, great oppression of the 
breast, palpitation of the heart, a weak, and sometimes 
intermitting pulse, an involuntary flow of tears, bilious 
vomitings, &c. All these symptoms grow worse towards 
night: the patient is easier when up, than in bed, and is 
ver^ desirous of cool air. 

"Regimen. — The food ought to be light and easy of 

digestion. Boiled meats are to be preferred to roasted, 

and the flesh of young animals to that of old. All windy 

food, and whatever is apt to swell in the stomach, is to 

M 



322 OF THE ASTHMA. 

be avoided. Light puddings, white broth, and ripe fruits, 
baked, boiled, or roasted, are proper. Strong liquors, 
of all kinds, especially malt liquors, are hurtful. The 
patient should eat a very light supper, or rather none at 
all,* and should never suffer himself to be long costive. 
His clothing should be warm, especially in the winter 
season. And all disorders of the breast are much reliev- 
ed by keeping the feet warm, and promoting the perspi- 
ration; a flannel shirt or waistcoat, and thick shoes, will 
be of singular service. 

"But nothing is of so great importance in the asthma, 
as pure and moderately warm air. Asthmatick people 
can seldom either bear the close heavy air of a large town, 
or the sharp, keen atmosphere of a bleak hilly country; 
a medium therefore between these, is to be chosen. The 
air near a large town is often better than at a distance, 
provided the patient be removed so far as not to be affect- 
ed with the smoke. Some asthmatick patients breath 
easier in town than in the country; but this is seldom the 
case, especially in towns where much coal is burnt. 
Asthmatick persons who are obliged to be in town all 
day, ought at least to sleep out of it. This will often 
prove of great service. Those who can afford it, ought 
to travel into a warmer climate. Many asthmatick per- 
sons, who cannot live in Britain, enjoy very good health 
in the south of France, Portugal, Spain, or Italy. 

"Exercise is of very great importance in the asthma, 
as it promotes the digestion, preparation of the blood, 
&c. The blood of asthmatick persons, is seldom duly 
prepared, owing to the proper action of the lungs being 
impeded. For this reason, such people ought daily to 
take as much exercise, either on foot, horseback, or in a 
carriage, as they can bear. 

(i *\r°dicine. — Almost all that can be done by medi- 
cine, in this disease, is to relieve the patient when seized 

* I would rather advise asthmaticks, at all times, to take^ small 
meals and repeat them often. And in a majority of cases, they will 
be the better of a I fght supper. Persons much reduced will gene- 
rally find benefit from taking a little food, once or oftener, during the 
night. A desideratum here, seems to be, neither to suffer the sto- 
mach to be entirely empty, nor overloaded. 



OF THE ASTHMA. 323 

with a violent fit. This, indeed, requires the greatest 
expedition, as the disease often proves suddenly fatal. 
In the paroxysm or fit, the body is generally bound; a 
purging glyster, with a solution of assafcetida, ought 
therefore to be administered, and if there be occasion, it 
may be repeated two or three times. The patient's feet 
and legs should be immersed in warm water, and after- 
wards rubbed with a warm hand or dry cloth. Bleed- 
ing, unless extreme weakness, or old age forbid it, is 
highly proper.* If there be a violent spasm about the 
breast or stomach, warm fomentations, or bladders filled 
with warm milk and water, may be applied to the part 
affected and warm cataplasms to the soles of the feet 
The patient must drink freely of diluting liquors, and 
may take a tea spoonful of the tincture of castor and of 
saffron mixed together, in a cup of valerian tea, twice or 
thrice a day. Sometimes a vomit has a very good effect, 
and snatches the patient from the jaws of death. This, 
however, will be more safe after other evacuations have 
been premised. A very strong infusion of roasted coffee, 
is said to give ease in an asthmatick paroxysm. In the 
moist asthma, such things as promote expectoration or 
spitting are to be used; as the syrup of squills, gum am 
moniack, and such like. A common spoonful of the syrup, 
or oxymel of squills mixed with an equal quantity of 
cinnamon water, maybe taken three or four times through 
the day, and four or five pills, of equal parts of assafce- 
tida and gum ammoniack, at bed time. After copious 
evacuations, large doses of ether have been found very 

* Old age can never be an objection to bleeding. The aged can- 
not bear large bleedings, but their diseases, in general, yield to small 
repeated bleedings more readily than at any other period of life, 
Vomits rack them to pieces, purges sicken and exhaust them; but 
reasonable bleeding, they not only bear with safety, but iu diseases 
of high excitement, it is the only remedy that will either give speedy 
relief, or prevent congestions, so often the consequence of fever left 
unsubdued by this remedy. Further, sweating subjects them to take 
cold, so that bleeding, and diureticks, are remedies especially adap- 
ted to the aged. Therefore, in asthmatick, as well as in the dis- 
eases, in general, of the aged, we are not to ask "how old art 
thou?" but examine into the force or violence of the symptoms, Sec 
and prescribe accordingly. 



3S4 OF ANGINA PECTORIS. 

efficacious in removing a fit of the asthma. I. have like- 
wise known the following mixture produce very happy 
effects: To four or five ounces of the solution of gumam- 
nioniack, add two ounces of simple cinnamon-water, the 
same quantity of balsamick syrup, and half an ounce of 
the paregorick elixir. Of this, two table spoonfuls may 
be taken every three hours." 

To these remedies, I shall now add, that I have found 
more benefit in the paroxysms of asthma, after evacua- 
tions, from the use of sugar of lead and opium, than any 
other remedy. In weakly patients, where the blood 
vessels are not much disturbed, this medicine may safe- 
ly be given immediately: Take sugar lead twelve grains, 
opium three grains, make six pills: of these, the patient 
may take one every hour, till the disease abates, or till 
three, four, or the whole six are taken, according to the 
sex or strength of the patient. This will generally check 
the fit, and it will now be advisable to follow these pills, 
with some of the above remedies. Much benefit has 
been derived, in some cases, from smoking the leaves of 
the Jamestown weed or stramonium in the fits. Dr. 
Miller, of this state, who has been severely affected with 
this disease, speaks of it in high terms. 

Lastly. Asmaticks must exercise, dress carefully, 
keep warm dry feet. And they will find benefit from 
the occasional use of the cold bath, and taking pills of 
assafoetida and iron filings in the intervals. 

section v. 

Of Angina Pectoris. 

This disease is treated of in the appendix to the article 
on medicine, in Dobson's Encyclopaedia. Dr. Heberden 
is said to be the first who has written upon this disease. 
It seizes those who are subject to it when they are walk- 
ing, and particularly when they walk soon after eating, 
with a most disagreeable and painful sensasion in the 
breast, which seems to threaten immediate death: but 
the moment they stand still, all uneasiness vanishes. In 
all other respects, the patients, at the beginning of this 



OF ANGINA PECTORIS. 325 

disorder, are well, and have no shortness of breath; from 
which, the angina pectoris is wholly different. 

Alter it has continued some months, the fits will not 
cease instantaneously on standing still; and it will come 
on, not only when the patients are walking, but when 
they are lying down, and oblige them to rise up every 
night, for many mouths together. In one or two very 
inveterate cases, it has been brought on by the motion 
of a horse or carriage, and even by swallowing, cough- 
ing, going to stool, speaking, or by any disturbance of 
mind. The subjects of it are principally men, but cases 
of it have been found in boys and women. The best 
opinion which I can form of this complaint, (which has 
been spoken of by many eminent men since Dr. Heber- 
den's reports, as Fothergill, Wall, Percival, Haygarth; 
and by Smyth of Ireland, who has probably suggested 
the best, or only method of cure,) is, that it is a gouty af- 
fection of the heart. This disease has mostly terminated 
in sudden death. But I entertain strong hopes, that if it 
is viewed as a gout of a middle grade, and reasonable 
evacuations by blood-letting, &c. advised, in the first 
paroxysms, and in the intervals treated according to the 
advice of Dr. Fothergill, together with immediate re- 
course to one or more issues, according to circumstan- 
ces, this disease may often be cured. 

Such persons are advised by Fothergill, not toeatio- 
racioasly; to be particularly abstemious, in respect to 
every thing heating; spices, spirits, wines, and all fer- 
mented liquors; to guard most scrupulously against pas- 
sion, or any vehement emotions; and to make use of all 
the usual means of establishing and preserving general 
health; to* mitigate excesses of irritability or pains, if 
they quicken the circulation, by anodynes; to disperse 
flatulencies when they distend the stomach, by moderate 
doses of carminatives; among which, perhaps pepper- 
mint water may be reckoned one of the safest. But since 
obesity is justly considered as a predisposing cause, he 
insists on the necessity of preventing an increase of fat 
by a vegetable diet, and using every practicable method 
of promoting the thinner secretions. 



3&6 OF THE GRAVEL AND STONE. 

I have twice seen a disease of this kind blended with, 
hysterical affections, which I have spoken of under .the 
head of gout. I shall conclude this article by admonish- 
ing the reader, that all the usual means of invigorating 
the general system, with one or more issues open, is his 
principal hope, and in the paroxysms large doses of 
ether, tincture of assafcetida, &c. in reduced habits; and 
moderate bleeding, and the use of mineral tonicks after- 
wards, in first paroxysms, or in strong habits. 

section vi. 
Of the Gravel and Stone, 

It is said, the gravel or stone is occasioned by un- 
wholesome waters, containing stony or calculous malter; 
unwholesome windy food; by high living; a sedentary 
life; lying long on the back; an hereditary disposition; 
the use of strong and astringent wines. People at every 
period of life are subject to stone, but it is mostly found 
in persons who have been affected with gouty or rheu- 
matick pains. In short, stone and gravel is attended 
with all the usual symptoms of vibrating or retrocessent 
gout; and often accompanies regular or inflammatory 
gout, being a congestion commencing in the kidneys, and 
growing out of an infarction of these organs. 

Gravel in the kidneys occasions pain in the loins; 
sickness; vomiting, and sometimes bloody urine. A 
stone in the ureters occasions more acute pain reaching 
down towards the bladder; the thigh and leg of the side 
affected are benumbed, and the testes are sometimes 
drawn upwards, and there is more or less obstruction of 
urine. A stone in the bladder occasions pain in the low- 
er part of the belly, and is particularly felt at the time of 
making water, and immediately afterwards; the urine 
can, often, only be discharged by drops, and is some- 
times bloody, particularly after riding in a carriage, or 
more especially on a horse: there is occasional discharges 
of raucous, which is either white and thick, or at other 
times even fetid, and accompanied with small particles 
of gravel. There is a needless inclination to go to stool, 



OF THE GRAVEL AND STONE. 327 

arising from irritation communicated to the rectum. In 
the male, there is an unpleasant stinging itchiness about 
the end of the urethra; and in the female, a similar irri- 
tation about the urethra, and often a most tormenting 
bearing down of the uterus, accompanied with pain and 
much irritation of this organ, which sometimes excites 
considerable fever. These symptoms are generally suf- 
ficient to enable us to distinguish cases of stone and gra- 
vel, at least, so far as is necessary in directing to a suit- 
able remedy. It will, however, always be necessary for 
the surgeon, to determine by sounding in the bladder, 
with a suitable sound, or catheter, whether mere gravel 
or a stone is present, before he could think of an opera- 
tion. 

Persons subject to this disorder should avoid much 
windy vegetables, or gross fat diet. They should livft 
temperately, but not too low; mild animal food, and even 
a little salted meat, occasionally, will be proper. Milk 
with ginger, or horseradish boiled in it, is a good arti- 
cle: well boiled onions, asparagus, spinage, radishes, 
and well boiled turnips, and cellery, are perhaps the 
best vegetables. They should drink mild mucilaginous 
drinks, as milk and water, slippery elm, gum arabick, 
quince seed, or other pure mucilage may be used; or in- 
fusions of parsley, march mallows, or linseed. In weak- 
ly habits, a little good gin is allowable, or other nice old 
spirit with a drop or two of oil juniper. 

Much may be done in the early stage of this disease, 
by exercise, and such other remedies as are calculated 
to strengthen the system; and iron filings in particular, 
will be useful as a tonick; but when the disease has pro- 
gressed, exercise to any great extent is impossible; it 
ought in every case to be pursued in some form, so long 
as it can be borne. Soap of the mildest kinds, as cas- 
tile, has been taken in large quantities with good effect 
and also lime water used freely; but we should alway? 
commence with small doses, and increase them gradual- 
ly. Half an ounce of soap, and half a pint of lime wa- 
ter per day, are reasonable portions of these articles: 
they may be continued for years, at intervals, but a too 
constant use of them will injure the stomach. A decoc- 



328 OF DYSPEPSIA. 

tion of raw coffee berries; and of the wild carrot seeds, 
sweetened with honey, has been found useful in some ca- 
ses. From twenty to sixty grains of powdered uva ursi, 
taken in milk, has been found useful. 

In inveterate cases, particularly in the decline of life, 
the free use of laudanum, and the warm bath become in- 
tlispensably necessary. I suspect a gouty fever often 
accompanies cases of stone or gravel, and in fits particu- 
larly severe, we will give much relief by bleeding; nor 
need we be afraid to repeat it several times, if the symp- 
toms run high. When the kidneys, uterus, &c. take on 
much irritation or inflammation, which is often occasion- 
ed by exercise on a rough-gaited horse, we must bleed, 
give mucilage, and enjoin abstinence for a few days. In 
the intervals, I have uniformly seen the most marked 
advantages from the use of large quantities of magnesia, 
and mucilage. To most persons, it is more agreeable 
than soap or lime water, and I believe it better, because 
it keeps the bowels open. It will always be a deside- 
ratum to get magnesia of a good quality. 

SECTION VII. 

Of Dyspepsia. 

It has been pretty generally supposed, that dyspepsia, 
is seldom a primary, or a local disease of the stomach. 
I suspect, it is most commonly a gouty affection. It is 
known to follow gouty habits invariably. No disease 
admits of a greater uniformity of treatment; so that for 
dyspeptick symptoms, we are to rest our indications of 
cure, first on correcting the acidity present, and second- 
ly, by means of mild tonicks, give tone to the stomach. 
The disease is known by irregular appetite, mostly bad; 
occasional nausea; dejection of spirits; flatulency of the 
stomach, and bowels; cardialgia, or pain at the pii of the 
stomach; much belchings of sourish, or other unpleasant 
tasted fluids, Avhich rise up, and are sometimes thrown 
up in mouth fuls; slight spasms are often felt, headach is 
frequently one of the most distressing symptoms; great 
oppression about the stomach after eating; with general 



OF DYSPEPSTA. 329 

languor and giddiness. These symptoms sufficiently 
characterize dyspepsia, and they are generally more or 
less violent, or constant, as the patient conducts respect- 
ing his food and drink, and general condition. It 
may be remarked of dyspepsia, that although acidity is 
mostly present, there is nevertheless, exceptions, where 
the contents of the stomach offend in form of oxyds, and 
in other cases, these fluids have even been found alka- 
line; in these cases, it must be obvious, acids are the 
proper correctors; and in all cases, where sourness is not 
plainly perceived, or where magnesia in reasonable quan- 
tities does not loosen the bowels, we are to suspect this 
condition of the gastrick liquor. The depraved fluids 
of the stomach may be corrected by magnesia; but in 
some cases it must be calcined; soda water highly char- 
ged with fixed air; prepared chalk; or white oxyd of 
bismuth: and also by the elixir vitriol, or nitrick acid: 
and in some cases the acid of lemons, or even nice vine- 
gar rendered aromatick by a little cayenne or other pep- 
per: these acids will often succeed even in cases where 
acidity abounds, for they are as capable of destroying 
the phosphorick, and other weak acids in the stomach, 
as the alkalies are. These remedies with emptying the 
stomach in severe cases, by a gentle vomit* or by drink- 
ing freely of chamomile or carduus tea, and opening the 
bowels, will generally remove the symptoms for a time: 
but as debility either partial, or, mostly, general, is the 
cause of dyspepsia, we are only to expect permanent re 
lief from such remedies as are calculated to invigorate 
the body. These have been so fully pointed out in va- 
rious parts of this work, that I shall briefly state a few 
leading aims. 

Exercise, and particularly on horseback; or labour- 
ing; the occasional use of the bath, cold, warm, or tepid, 
according to circumstances; a diet consisting principally 
of light animal food; dry plain biscuit, rice, barley, and 
potatoes well boiled, in general, are preferable to fer- 
mented bread: boiled onions; milk with horseradish, or 
ginger, boiled in it. A glass of choice wine, or a little 
old spirit and water, may be taken by persons in the de- 
cline of life; but the young had better use a few drops of 
4& 



330 of goutier, on goitrl. 

elixir vitriol, or increase the quantity of condiments. 
Cold water may generally be used, or cold pleasant bit- 
ter infusions; sometimes good porter is agreeable. But 
in general, fermented liquors, much butter, cheese, fat, or 
much salted meat, is to be avoided. In general, such 
people will be enabled by attending to their diet, to dis- 
cover what agrees best with the stomach, for each case 
has some peculiarity. 

A little salted meat once a day will impart an agreea- 
ble stimulus and tone to the stomach; and in warm wea- 
ther it is indispensably necessary. With the above re- 
gimen our views will often be promoted, by using occa- 
sionally as to nicks, iron filings combined with the gums; 
bitters as powdered bark, columbo, or gentian; the elixir 
vitriol; white oxyd of bismuth. The bowels must be 
kept open; nor is a looseness, whkh sometimes occurs, 
in dyspepsia to be considered as answering this purpose, 
on the contrary, it generally indicates a necessity for 
mild laxatives; much purging is perhaps always injuri- 
ous to such patients, and therefore, after mild laxatives 
we ought to check it by laudanum, if necessary. 

section VIII. 
Of Goutier, or Goitre. 

This is an enlargement of the thyroid gland, or an un- 
pleasant swelling of the neck. It prevails in Switzer- 
land, some parts of New-England, and in some parts of 
the western country, adjacent to the Ohio; but cases of 
it are to be met with in every part of this country, in 
which I have travelled. All the cases of this disease 
which I have seen, that were of long continuance, were 
accompanied with asthmatick symptoms. There is ca- 
ses, on record, where removal has effected cures, but in 
general this affection of the throat is associated with some 
other visceral affection, and I suspect, it is only to be 
removed by occasional bleedings, and one or more issues 
kept open for a long period, or during life. Exercise, 
particularly in the form of travelling, the cold bath, and 



OF SCROFULA. SSi 

such tonicks as are most durable and least stimulant, 
should be used. 

Iu the early stage of it, I think it highly probable, that 
by adding to the above remedies, frequent applications 
of the extract of lead to the part affected, the disease may 
be arrested. I think it particularly necessary to keep 
the feet dry and warm. And the issues will probably 
answer best in the calf of the leg. 

Several causes have been assigned as producing this 
disorder, such as snow water, cold climates, and hilly 
countries. There appears to be something of an ende- 
mick character in this disease; but 1 suspect it is occa- 
sioned most frequently, by persons going barefooted, 
who are predisposed to gout. It follows, that, in places 
where goitre prevails, females in particular are to pay 
a scrupulous attention to keeping the feet and legs warm. 
If they are more exempt from regular gout than men, 
they are more liable to goitre, and to misplaced gout: 
and, in this country, suffer more from neglecting to keep 
the feet and legs warm, than from any other circum- 
stance. 

SECTION IX. SUBSECTION 1. 

Of Scrofula. 

In treating on scrofula, I have thought proper to de- 
part from tbe common tract, and suggest some new ideas, 
which I think calculated to lead to a rational and safe 
practice. I shall divide the subject into strumosa raclii- 
tialis, or rickets: strumosa glandulosa simplex, or sim- 
ple, scrofula of tbe glands: and strumosa maligna, or 
malignant scrofula. Eacb of these forms of this disease, 
partake of different grades, and like all other diseases 
affecting different parts of the system, are often blended, 
©r transformed from one crade to another. 



332 OF RICKETS, OR RACHITIS. 

SUBSECTION 2. 

Of Rickets, or Rachitis. 

A simple rachitis usually commences with a looseness; 
flabbiness of the skin; a swelling of the abdomen, while 
the muscles in general grow lean; a flaccid tumour of the 
head and face; the joints appear enlarged; the patient 
becomes weak, and languid; the bones soft and yielding, 
so tnat if the child has been walking, it becomes gradu- 
ally weak and tottering, till at length it is unable to walk; 
and this is often rendered more difficult on account of an 
enlargement of the head, which often occurs: the sutures 
of the head open, the breast becomes distorted, the 
ribs knotted or crooked, the abdomen becomes still more 
protuberant, the teeth become blackish, and the tongue 
generally falters. And if these symptoms are not ar- 
rested, the whole of the solids become dissolved down, 
and the patient having lost all power to support himself, 
dies. In. most cases, however, this disease would even- 
tually wear off; but not without much deformity. My 
principal reason for placing rickets as a variety of scro- 
fula, is to caution persons who have been affected with 
this disease in infancy, that they are disposed to scrofu- 
la, and must be circumspect in pursuing the strictest re- 
gularity. This form of scrofula is principally found in 
young children. 

In attempting its cure, we are always to attend to 
keeping the alvine excretions regular; this with perse- 
verance in the following tonicks, using them alternately, 
will mostly answer our purpose: Iron filings made into 
pills, with extract of bark; or the iron combined with 
a little gum myrrh, and crumb of bread; from five to 
twenty grains of filings per day, should be given; phos- 
phate of lime, in doses, of from ^ve to fifteen grains, 
twice a day. In low cases muriated tincture of iron, 
with the alternate use of the above articles; we are also 
to use diligent frictions applied to the whole body, and 
there is strong reason for believing frictions with oil, 
would be useful. The cold, or tepid bath, must be 



OF MALIGNANT RICKETS. 333 

constantly used, and such exercise as the patients can 
take, or sustain, should never be omitted; they should 
wear flannel next the skin, and the utmost attention paid 
to keeping them dry. Their diet must be light, but nu- 
tritious; milk boiled with ginger, or horseradish, or a 
little pepper; and dry water biscuit, should constitute a 
large portion of the diet; light animal food, and occa- 
sionally a little salted meat will be proper; and a glass 
of choice wine may be allowed. A little ripe fruit may 
be allowed; all unripe fruit or vegetable trash, are to be 
withheld; nice fresh jelly of calves feet, &c. are proper. 

subsection 3. 

Of Malignant Rickets. 

A more malignant form of this disease, because more 
concentrated on one particular part of the body, is seen 
in white swellings, usually so called; the hip disease, 
and the spina bifida or disease of the spine; these are all 
but varieties of rachitis, of a more malignant form. 
And the same general indications of cure are necessary, 
with some variety in the local or topical applications. 
This form of scrofula is usually ushered in by violent 
inflammatory symptoms, particularly when it attacks the 
hip, or knee: the symptoms generally run high where 
any of the larger joints or bones are attacked; the in- 
flammatory symptoms are less marked when the spine is 
attacked. In these cases, active measures should be 
speedily adopted; bleeding from the arm; purging; sca- 
rifications, on the part pained, with cupping glasses; 
leeches; blisters: after these remedies have been, speedi- 
ly, carried, as far as may be considered safe, we may 
apply warm fomentations, and give anodynes combined 
with ipecacuanha or sweet spirit of nitre, and await sup- 
puration, which is often tedious, and requires onion 
poultices; but in all cases, it is improper to continue wet 
or dampness of any kind, for a length of time: gum plas- 
ters will answer better. 

In the disease of the spine, we are never to apply poul- 
tices; a warm gum plaster may be applied; if the disease 
advances, our only hope is issues, on either side of the 



334 OF SCROFULA IN THE GLANDS. 

spine, kept open with savin ointment. This form of the 
disease usually attacks weakly children: and seldom re- 
quires severe evacuations; the principal indication, here, 
is to strengthen the general system, and keep open the 
issues. 

All machines, tight bandages, &c. are to be carefully 
avoided, they are the offspring of ignorance, or officious- 
ness, and never fail to harass the little sufferers with 
more pain than the disease. The cold bath, frictions, 
and such exercise as can be borne, are the only things 
which will support an automaton machine. Let me ad- 
monish every head of a family to bury all these tormen- 
ting machines with the "quiescent momentum" of a late 
machine, said to possess powers of perpetual motion. I 
am not singular in these opinions; professor Davidge has 
taken much pains to propagate this important advice, 
against these machines. A staff or crutch, will often 
be useful, and even with these long standing should be 
avoided. 

The machines worn for a weak back or legs, may be 
called, emphatically, yokes of folly , designed to support 
the back, but break the heart with vexation, and double 
labour, owing to the obstructions put upon the circula- 
tion. 

SUBSECTION 4. 

Of Scrofula in the Glands. 

I come now to speak of strumosa gland ulosa simplex, 
or the simple scrofula of the glands. This form of the 
disease is known by hard indolent sw ellings under the 
chin: behind the ears, &c; they go on mostly to enlarge 
gradually, then, sometimes, go away in the same gradual 
manner; at other times they go on to increase in size and 
number, and become painful, suppurate slowly, and then 
discharge a thin watery or brownish liquid. Sometimes 
the arm pits, groin, hands, eyes, mammae, &c. are affec- 
ted in a similar maimer. The lungs, liver, spleen, &c. 
are also liable to strumous affections; but this form of 
scrofula seldom affects the viscera; a permanent swell- 



OF MALIGNANT SCROFULA. 335 

ing of the upper lip, is reckoned a strong mark of a 
scrofulous habit. 

In this form of the disease, the free use of the bark, 
iron filings, cold bathing, travelling, with the usual ex- 
act attention to diet and regimen generally, which has 
been pointed out for rickets, are the principal remedies. 
If the case becomes inveterate, tending to obstinate sup- 
purations, and ulcerations, advantage may be expected 
from alternating the use of hemlock, with the bark. 
But I think it clearly established, that the very free use 
of the bark, and cold bath, with due attention to keep- 
ing the bowels regular, by opening them with phosphate 
of soda, when costive, and restraining a looseness when 
necessary, with small doses of laudanum, are the only 
means likely to arrest this disease. Mercury is never 
useful, and is attended with much danger. 

subsection 5. 

Of Malignant Scrofula, or Cancer, §*c. 

Stramosa maligna is found in the form of scirrhus j 
and cancer; I shall speak of them conjointly, and wish 
merely to premise, that cancerous ulcers sometimes oc- 
cur without scirrhus having preceded; but from the 
frequent termination of scirrhus in cancer, we are war- 
ranted in considering them one and the same disease; 
scirrhi being incipient or occult cancers. 

In these diseases, when they are locally situated, we 
are to extirpate the part, and thus remove the centre of 
the disease; after which suitable remedies may subdue 
the slighter taint of the general system. The removal 
of these tumours is the business of the most experienced 
surgeon, but it may be proper to point out those cases, 
which at an early stage, may generally be removed, these 
are scirrhus of the mammce, of the testes, and tumours 
generally which are superficially situated. In that va- 
riety of scrofula, known at present by the name of fun- 
gus hcematodes, amputation is alone to be trusted. 

The liver, stomach, and uterus, are more especially 
liable to scirrhus: these are known by pain and burning 



336 OF SYPHILIS, OR LUES VENEREA. 

in the part affected, and a hardness is soon perceptible, 
by pressing on the part. Such cases require the most 
skilful attention, and therefore, I shall conclude this ar- 
ticle with a few general observations. 

We are never to apply external remedies to scrofu- 
lous sores, unless they break: in common cases, an oint- 
ment with a few drops of oil of savin in it, or some of 
the powdered leaves in common basilicon is the best 
dressing. 

In malignant cases we may use the carrot poultice, 
sprinkle the part with powdered savin leaves, touch it 
with the juice of garlick, or a weak solution of arsenide; 
but where these articles produce irritation and pain, they 
should be omitted, and the carrot poultice, with frequent 
fomentations of hemlock, or Jamestown weed used. 
Exercise, and frictions, accompanied with mild nutri- 
tious diet, are proper in all cases of scrofula, but in the 
malignant we are not to expect any benefit from the cold 
bath, if it be not really dangerous; neither is any benefit 
to be expected from the bark, in the malignant scrofula: 
the free use of hemlock, and perhaps the oecasional use 
of a solution of arsenick, with avoiding all heating 
drinks, or harsh articles of diet, disturbances of the 
mind, and attention to the bowels, are our hopes, to- 
gether with occasional anodynes, to keep down pain or 
irritation. An incipient scirrhus of the liver, may pro- 
bably be arrested by mercury, but in all other cases it is 
useless or hurtful. 



section x. 
Of Syphilis, or Lues Venerea. 

In treating on this disease, I consider it a matter of 
primary importance, to point out the symptoms by which 
it maybe known. Persons are sometimes found willing 
to believe that scrofula and other diseases are venereal; 
but more frequently, persons are found who wish to con- 
ceal this disease, under pretence of having some other. 
Moreover, we are assured by many most reputable au- 
thors that this disease may be communicated by simple 



OF SYPHILIS, OR LUES VENEREA. 337 

contact, as touching the virus with a part from which the 
scarf skin is removed, sucking a venereal person, with 
a sore mouth, &c. in these cases it may be of great im- 
portance to distinguish this disease from scurvy. But 
although I have no doubt of such communications pro- 
ducing this disease, I am confident they are very rare, 
and many people conceal their own vices under a cover of 
this kind. I believe ninety-nine cases of a hundred, 
are the offspring of impure coition, and therefore not only 
might be avoided, but cannot be contracted but at the 
expense of virtue, of one of the parties, in all cases. 

I shall take occasion to observe here, that the more 
artificial our diseases, the more difficult are they of cure; 
and this is strongly exemplified in syphilis and gout. 
When the usual local symptoms of a, virulent {gonorrhoea, 
as chancres, buboes, phymosis, &c. do not yield to the 
usual remedies, or if these heal, and break out again, 
without a renewed infection, we are to suspect the gene- 
ral system is affected. If ulcers break out in the throat, 
pains in the shins, with nodes or little knots upon the 
bone; ulcers in various parts of the body, or ill looking 
blotches, or eruptions, unattended with itching, we may 
generally conclude the case is venereal. Venereal ulcers 
may be distinguished from scorbutick ones from these 
circumstances: Venereal ulcers never affect the gums 
first, but generally commence in that part of the mouth 
called the fauces, more commonly in the tonsils, or uvula, 
of the upper part of the throat; scorbutick ulcers affect 
the gums first. Venereal ulcers are red around their 
edges, scorbutick ones are livid. Venereal ulcers are 
mostly deep and covered at bottom with white or yellow- 
ish sloughs, scorbutick mostly put out loose fungi. 
Venereal ulcers are apt to rot the subjacent bones, scor- 
butick almost never. Venereal ulcers are well defined 
in their edges and mostly circular, scorbutick are more 
extended and undefined. Venereal ulcers are callous 
in their edges, scorbutick ones are not so. Venereal 
ulcers are apt to spread from the mouth to the nose, 
scorbutick are not. Lastly: scurvy may be known by 
difficult breathing, remarkable lassitude, rotten gums, 
and swelled legs. But our greatest danger is that of 
43 



388 OF SYPHILIS, OR LUES VENEREA. 

mistaking scrofula for syphilitich affections; nor in ge- 
neral can we determine without much experience in these 
diseases, unless it be from the circumstance of knowing 
we have been infected with syphilitick poison; or where 
it is preceded with the most usual forerunners, as buboes, 
chancres, &c. or from the circumstance that the patient 
is evidently scrofulous; and even this will sometimes de- 
ceive us, for scrofula and syphilis are often blended. 
And further, a scrofulous taint which lies dormant, is 
sometimes roused up by syphilis, but more especially 
by mercury used for its cure. It follows, that persons 
of scrofulous habits run double risk from contracting 
lues venerea, for they cannot be cured of syphilis with- 
out mercury, nor use it in scrofula without risk: and I 
have elsewhere said, that, I believe most of the dread- 
ful consequences which sometimes follow the use of mer- 
cury, and what is usually called the mercurial disease, 
is nothing but aggravated scrofula. 

Upon the whole, I consider it one of the most impor- 
tant affairs in mediciue to distinguish between scrofula 
and syphilis, in some cases; and as much mischief may 
arise from mistakes, it behooves every patient to take the 
best advice. I therefore, shall conclude this article with 
a few general observations. I have cured lues at every 
stage of the disease by the mildest remedies, which 
have been proposed for this disease. Give from three 
to five grains of calomel, according to circumstances, in 
pills; suffer these to purge the patient a few days; and 
if the least affection of the gums occurs, quit the calomel 
till this wears off. After the patient has been reaso- 
nably purged, if necessary, combine opium with the 
calomel. 

If the case is recent, we should bleed once or twice, 
and enjoin a low diet with mild drinks. But in con- 
firmed cases, we may commence at once with pills of 
calomel and opium, observing always to omit the medi- 
cine when the gums are affected, till this wears off, and 
then begin again; after pursuing this course for a few 
weeks, we should quit the medicine, and put the patient 
on the use of nitrick acid; with this, should be used de- 
coctions of mezereon, sarsaparilla, sassafras, or burdock; 



OF SYPHILIS, OR LUES VENEREA. 339 

this course is to be continued for a few weeks, and then 
(hanged again for the calomel and opium. 

In all reduced habits, or in cases accompanied with 
scrofula, we are to commence with short courses of the 
mercury, and longer courses of the acid, &c. In good 
habits and recent cases, we are to reverse this proce- 
dure. In all scrofulous habits, we should constantly 
use the bark, in conjunction with other remedies. 

By this treatment we can arrest syphilis in every 
stage, (and I speak from actual experience,) provided 
due attention is paid to avoid catching cold, by keeping 
the feet and legs warm and dry, and wearing flannel 
next the skin, dressing warm, avoiding heating articles 
of diet or drinks, venery, and fatigue, and excess of 
every kind: but free exercise is always necessary in 
good weather. The patient is also to avoid rash ex- 
posure to night air, and also that of cool mornings and 
evenings, and getting wet, or rashly drinking cold wa- 
ter when warm. In recent cases, animal food, and 
spirits, and spiceries, must be avoided: in those more 
confirmed, or iu weakly habits, a tolerable generous di- 
et, with a little gin and water, may be used, more 
especially if the patient has been accustomed to ardent 
spirits. 

For local affectious, as buboes, chancres, ulcers of the 
mouth, or sores of other parts of the body, if ulcerated, 
a wash of calomel, honey and water, together with daily 
washing the parts very clean, with mild soapsuds, will 
answer every purpose. This wash may be made by 
rubbing half a dram of calomel with two small tea spoon- 
fuls of honey, to which, add two ounces of cold water. 

For venereal inflammation of the eyes, or buboes not 
open, mercurial ointment is the best remedy; but for the 
eyes, the ointment should be fresh, and contain nothing 
but the quicksilver, and the best fresh lard. It will be 
advisable, in ulcers of the mouth, to gargle frequently 
with a weak decoction of bark, containing a little soda. 

I am satisfied from observation, that the use of mer- 
curial ointment is one of the most unsafe forms of this 
medicine. We can make little or no calculation on the 
effects which will follow, and patients are often saliva- 



340 OF THE YAWS. 

ted in this way before they are aware of it: this is never 
necessary, and to persons who are going about, or to 
scrofulous patients, it is always dangerous. Besides, it 
is a dirty practice, as disgusting as it is unnecessary. 
In cases of fever, where we wish to salivate, and where 
of course the patient is confined to the house, the oint- 
ment should always be preferred; or accompany mercu- 
ry in some other form. 

Much confidence has been placed in the use of the cor- 
rosive sublimate: it often answers a good purpose; but 
the calomel is more mild, and equally effectual: besides, 
serious injury is often done the stomach and appetite, 
by using corrosive sublimate,* which I have never seen 
follow the use of calomel. Where there is much pain, 
we should use anodynes freely; but in general we must 
endeavour to avoid the long continued use of opium. 

Let me solemnly admonish every person, to beware 
of persons who pretend to cure confirmed lues without 
mercury: they will either deceive you in giving it clan- 
destinely, or they will injure your constitution, and pos- 
sibly do away all chance, which you might have had, 
for its removal, by mercury. And further, never daub 
your skin with mercurial ointment, if you intend to go 
abroad during its use, or if you have any suspicions of 
scrofula. 



SECTION XI. 

Of the Yans. 

Much confusion or ambiguity exists respecting this 
disease, but from the best information which I have of 
it, it does not prevail among us, at least, not in the form 
known under the names of frambozsia guineensis, or 
americana, the former of which prevails in Guinea, and 
the latter in St. Domingo, &c. I saspect, what takes the 
name of yaws in the United States, is a combination of 
a slow or low grade of lues and glandular scrofula. 

* r This medicine has acquired a very great reputation in the pub' 
lick institutions in New York, brought about by Dr. Hosack. 



OF EPILEPSY. 341 

Such has been the case with all thccases I have seen, 
and when thoroughly confirmed, it is seldom if ever 
cured. But there is some consolation in the belief, 
which I think well founded, that those deplorable cases 
are always the consequence of neglect, or improper treat- 
ment on the part of the physician, or imprudence, &c. 
on the part of venereal patients. All these declarations 
comport with my observations on cases called yaws. 

It would seem to follow, that by avoiding the usual 
causes of lues, and by carefully attending to the speedy 
removal of it when caught accidentally, or at the ex- 
pense of decency and virtue, we may banish this uncouth 
name from the list of our diseases. Or, perhaps, no 
better term can be used than that of frambwsia for this 
compound disease, formed of scrofula and lues, more 
especially as the American people seem to have adapted 
the term yaws, to a low chronick state of syphilis. 

SECTION XII. 

Of Epilepsy. 

This disease is also known by the name of falling 
sickness, from the circumstance of the patient's being 
generally suddenly seized; and falls down, and some- 
times receives great injury from lire, bruises, cuts, &c. 

I have seen one most shocking case of an epileptick 
patient falling with his face against a hot stove. I was 
present, but the weather being cold, and not recollecting 
immediately that he was an epileptick patient, at my 
father's, he was suffered to remain a few r moments before 
the true state of his disease occured, for it was supposed 
he had merely stooped to warm himself, till the usual 
noise made by such people, called me to his assistance; 
and it appeared as though he would have been burned 
to death, if I had not been present, for he made no efforts 
towards relieving himself. This suggests a strong cau- 
tion, to those who are subject to sudden attacks, to avoid 
dangers of this kind. 

There are many cases where the fits are preceded by 
premonitory symptoms, which enable the patient to pre- 



84$ OF EPILEPSY, 

pare in some measure for the attack: these symptoms are 
pain and confusion of the head, lassitude, dread, noise in 
the ears, palpitation of the heart, uneasiness of the head, 
disturbed sleep, &c. these are often succeeded by cold 
tremulous like sensations, ascending upwards to the head. 
If the patient be standing he now falls, and generally 
utters a violent distressful cry, and these are often re- 
peated; the thumbs are drawn up into the hands, the 
eyes are distorted, the breathing is laborious; sensation 
is suspended; so that smelling, seeing, hearing, and 
feeling, are entirely suspended. Many other unpleasant 
symptoms occur, which it is unnecessary to mention, in as 
much as the above always sufficiently characterize epilep- 
sy. After these symptoms, if they occur in the day, 
the patient may be awoke, and he feels sore, and stupified 
for some time afterwards. Often, however, it attacks in 
sleep, and the patient, after the most violent fits, falls 
asleep again unconscious of what has happened, except 
from the soreness which is felt over the whole body. 
In inveterate cases, a pretty constant giddiness and con- 
fusion of the head continues. 

All search after the cause of this unpleasant disease 
has been fruitless, the dissection of persons who have 
died after being affected with epilepsy, has sometimes 
discovered organical affections of the brain, caries of the 
skull, indurations, collections of water, matter, &c; but 
in many cases no traces whatever were to be discovered. 

Cases of epilepsy are to be found where strong pres- 
sure upon the region of the stomach will suspend the 
fit, or check its violence, so that upon the whole, I 
imagine, epilepsy is as often the consequence of diseased 
viscera, and particularly of the stomach, as of disorders 
of the head. And indeed, from the remedies which have 
often been found useful in this disease, and sometimes 
cured it, I think it highly probable the stomach is the 
.seat of the disease, at least in those cases which yield 
to powerful tonicks. It is generally believed, epilepsy 
is incurable after puberty, but there are many cases on 
record, where they were cured after this period of life. 

I have generally been able to suspend the force of 
epilepsy, by the use of sugar lead, but it has always re- 



OF HYPOCHONDRIASIS. 348 

turned: but by a more free and long continued use of 
this article, I think it likely it might be cured, where there 
is no disorganization of parts, which must preclude all 
hopes from medicine. It behooves persons subject to this 
disorder, to live temperately, avoiding all excess in eat- 
ing, drinking, exercise, passions, venery, &c. Of all un- 
friendly things venery, and disturbances of the mind, are 
most conspicuous. With the strictest regularity with re- 
spect to exercise, which should be constant, but moderate, 
to diet, sleep, avoiding spirits, and much gross animal 
food, I should recommend the following course in pre- 
ference to any other. Take the flowers of zink for a 
few weeks, in the usual doses; then use iron filings and 
assafcetida, for a like period; succeed this with the sugar 
lead, in doses of from one to four or six grains a day; 
then stramonium in the usual doses; then the bark in the 
largest possible quantities, that the stomach will bear; 
then the cuprum ammoniacum. With these remedies 
we should open one or more issues, in some part of the 
body; and use the cold bath occasionally. Should a 
round of all the above powerful tonicks prove abortive, 
it will be advisable to go over them again, changing the 
order of them in some measure, so as to produce as much 
variety as possible. 

SECTION XIII. 

Of Hypochondriasis. 

It has been supposed by many unthinking people, 
that hypochondriasis is but an imaginary disease; and 
it is often unwittingly called blue devils, and other rude 
or trivial names. For that of spleen, there is some foun- 
dation; as from the days of Hippocrates, it has been 
supposed to be an affection of the spleen. But this dis- 
tressing malady, probably is seated in the three princi- 
pal organs of digestion, the stomach, liver and spleen; 
and the melancholy state of the mind is symptom atick of 
a languor, or perhaps owing to depraved functions of 
the organs enumerated; by which I think it highly pro- 



844 OF HYPOCHONDRIASIS. 

bable the blood, and animal fluids, are not sufficiently 
prepared. 

It is well known that reasonable pleasantry or mirthj 
Las a beneficial effect upon hypochondriacks, and sub- 
jects of other diseases, and hence it comes that well dis- 
posed persons, who wished to befriend or relieve such 
patients, by a prudent use of good humour, &c. have 
Drought the unthinking to suppose hypochondriacks are 
fit subjects for derision, and rude sport, because their 
disease is imaginary. But let me admonish all such, 
that this is an egregious errour, and as inhumane as it is 
ill founded. We know that all diseases are much in- 
fluenced by the mind; aud moreover, that the stoutest 
heart, or constitution is assailable by, and essentially go- 
verned, supported, or depressed aud even destroyed, by 
the operations of the mind. 

In hypochondriacks we have uuequivocal evidence of 
disease preceding, and giving rise and maintenance, to 
the gloom of the mind, this is manifested by the follow- 
ing symptoms: all the usual symptoms of dyspepsia; cos- 
tiveness, tormenting pains under the false ribs, which 
Sometimes become lancinating, burning, &c. disturbed 
sleep. Sometimes there is an inflation about the region 
of the stomach, or spleen, flushings of the face, and heat 
or prickling through various parts of the body, with slight 
twitching or quivering of the flesh, colicky, and cardial- 
gick pa'uis; to these and many other symptoms, which 
sometimes occur, succeed dread, and a great suscepti- 
bility to frights: then comes gloomy forebodings, and 
still more disturbed sleep, insomuch that such patients 
are often almost deprived of sleep, under an apprehen- 
sion that they will die without waking. When the dis- 
ease is confirmed, it is particularly characterized by er- 
rour of judgment respecting their own case, while the 
judgment, and other powers of the mind are correct on 
all other subjects; and also, by a propensity to dwell, 
with minuteness, on every trifling symptom which occurs. 
If the case becomes still more inveterate from neglect, 
improper management, &c. this disease sometimes ter- 
minates in fixed melancholy, or a gloomy low state of 



OF HYPOCHONDRIASIS. 345 

madness, often leading to a desire of death, and which 
too often is accomplished, violently hy their own hands. 

This disease is generally curable* or perhaps more 
correctly speak ins;, may mostly be mitigated hy suitable 
attention to regimen, exercise, and the occasional use of 
medicine. In all recent cases, and in the occasional ex- 
acerbations, small evacuations are essentially necessary, 
as bleeding, aloetick purges, gentle emeticks, and these 
are to be repeated till the symptoms .abate. In the in- 
tervals, I have no hesitation in pronouncing the use of 
iron, the cold bath, and riding on horseback, superiour 
to all other remedies, and I speak from what I have seen 
in the extensive practice of my father, who has fre- 
quently had these kind of patients, coming from a dis- 
tance; and often sent them home perfectly well; some of 
which never relapsed. It is, however, probable, that 
the change of scene, &c. which attended going to, ancj 
residing for some time with or near a physician, in 
whom the patient had confidence, had a large share in 
affording that relief, which invariably followed cases 
from a distance, in the practice of my father. And I 
feel confidence in recommending to hypochondriacks, to 
seek out some celebrated distant physician, in prefer- 
ence to taking medicine at home. 

The following course will generally succeed: take 
iron filings, gum myrrh, and assafoetida* each equal quan- 
tity: form these into pills of the usual size, and take 
four to six per day, drinking a small glass of a bitter 
infusion, made by steeping a little bark, chamomile, car- 
duus, centaury, orange peel, or gentian; either of these 
alone or combined* will answer; and a quart of water, 
and one gill of pleasant old rum, spirits or whiskey, (to 
prevent souring.) and one dram of salt of tartar. If the 
bowels are costive, give a little aloes and calomel. It 
will always he necessary to observe the state of the feces; 
if they are not blackened from the use of the iron* we 
should omit the salt of tartar, and give fifteen or twenty 
drops of elixir vitriol, before each meal, about an hour. 
If things progress well, we should discontinue the iron 
and bitters, once in every ten or fifteen days* and give 
the elixir vitriol, as above, without anv other medicine. 
44 



346 OF HYPOCHONDRIASIS. 

for tbree or four days. In all cases where evacuations 
are necessary, and in debilitated habits, and generally, 
in cases of long standing, we should give mild anodynes 
at night; half a grain of opium, with two or three grains 
of ipecacuanha, is the best form of the anodyne, as it is 
more durable in its effects than laudanum, and the ipeca- 
cuanha determines mildly to the surface. An anodyne 
plaster should be worn over the stomach. These reme- 
dies, with the occasional use of the cold or tepid bath; 
and constant riding on horseback, will render such peo- 
ple comfortable, and often wholly eradicate disease from 
the body. 
. Much benefit will, however, be derived from proper 
attention to the mind. Those who wish such persons 
well, are to avoid all rude jokes, and every thing like 
intimation, that cheerfulness is assumed merely to rouse 
them from imaginary evils; such conduct is generally of- 
fensive, and often drives such patients from society to 
gloomy retirement. Tfie better way is to listen with 
good nature, to their distressful relations, by times, but 
on all suitable occasions preserve a cheerful lively de- 
portment; endeavouring to recall all pleasurable subjects 
which may have preceded, or which may be anticipated, 
relating either to the patient, or his companions. If he 
takes offence at a too lively deportment, and seems to 
think it pointed at him, never argue or contradict him; 
yield the point, and after a seeming repentance for 
having given offence, go on, but not particularly in his 
presence, to cheer up those around you by lively airs of 
musick, or the sprightly gambols of children and young 
persons; always guarding against rude noise. The fre- 
quent company of agreeable neighbours, or when riding, 
endeavouring to connect it with business, will be beneficial. 
It will readily occur to the reader that I am address- 
ing myself particularly to the wife; but persons of every 
description may materially promote the welfare of suf- 
fering hypochondriacks, by suitable endeavours to amuse 
and call oil' their attention from their disease. It is also 
of importance that such persons avoid spirituous drinks, 
and gross, or much vegetable trashy food, or pickles, fats, 
and excess of every kind. The diet should consist 



OF IIYSTERICKS. 347 

principally of light animal food, with eggs, milk season- 
ed with ginger, horseradish or pepper, well boded 
onions, and occasionally a little garlick, as a condiment. 
Good coffee with bread, and a little nice butter, and a 
relisher of a little nice ham, salted beef, or fish is a good 
breakfast: but coffee in general should not be used more 
than once a day: water biscuit should occasionally be 
preferred to raised bread, and also well boiled rice, po- 
tatoes, or barley, &c; animal jellies are proper, and roast- 
ted or broiled animal food, is preferable to boiled; and 
broths, unless rich and in small quantities, are improper. 
It is to be particularly observed, that such persons 
neither fast long, nor eat full meals; they should eat 
more frequently, but upon the whole they should eat 
sparingly; and if any particular article is found to disa- 
gree, or to agree well, they must choose accordingly. 
For drinks, water should constitute their principal drink; 
and if it seems to disagree with the stomach, a slice of 
carefully toasted bread, without burning, will often make 
it agreeable; or very weak bitter cold infusions may be 
drank; an occasional glass of good wine after dinner, will 
mostly be proper; but such people must be cautious how 
they use fermented or spirituous drinks; they are never 
allowable in large quantities. Persons in the decline of 
life, may be the better of a little old spirit, of some kind, 
mixed with a little water; but it must be used with much 
caution, and can seldom be used with safety, as freely, 
as by persons of the same age in health. 

SECTION XIV. 

Of Hystericus. 

This disease nearly resembles hypochondriasis, but 
differs in some measure in its symptoms, and requires 
some difference in the method of cure. For the treat- 
ment of hysterick colick, the reader is referred to the ar- 
ticle colick. Hysteria has mostly been supposed to be 
a disease peculiar to females; but I have seen all its most 
marked symptoms in males. It occurs sometimes with, 
and often without, the most permanent symptoms of hy- 



348 OF HYSTER1CKS. 

pochondriasis. The disturbance of the mind in this 
disease is more transient, and violent, than in hypochon- 
driasis, consisting mostly of sighing, crying, talkative- 
ness, laughter, &c. wonderfully alternating each other: 
a choking sensation in the throat, from a feeling as 
though a ball was rising up; large quantities of limpid 
urine; sick stomach, vomiting, and colick. In some 
rare cases libidinous desires are excited. For permanent 
relief from hysterical habits, we are to pursue the means 
laid down for hypochondriacks; in the fits or exacerba- 
tions, we are to pursue a treatment somewhat different. 
In full habits we should bleed, give a gentle emetick, 
and then use diffusible stimuli in small doses, as 
ether, laudanum, spirit hartshorn, tincture assafcetida, 
peppermint essence, or mixtures of these; the juice of 
garlick, or rue, will often have a good effect. 

In reduced habits, we may generally content ourselves 
with emptying the stomach by draughts of chamomile or 
card mis tea; and in those still more reduced, this may 
even be dispensed with, and the diffusible stimuli just 
mentioned, given with considerable freedom: an ano- 
dyne plaster may be applied over the stomach. But in 
general a very weak dose of ipecacuanha should be 
given, where there is much nausea or vomiting. It will 
always be necessary to attend to the bowels; and mag- 
nesia, or a little calomel and aloes, where the bowels are 
not easily moved, will answer. In old age the tincture 
of rhubarb, or tincture of rhubarb and senna, will an- 
swer, or heira picra. Such patients should carefully 
pursue the regimen, &c. laid down for hypochondriacks; 
and it is especially necessary to guard against passions of 
the mind, and to keep the feet dry and warm; and here, 
as in all other cases of the valetudinary condition of 
the body, flannel should be worn next the skin. 

Persons much subject to hysterical affections, must 
carefully avoid indulgence in sensual pleasures; in deli- 
cate females it is often an exciting cause of the disease, 
and the offspring of the cohabitation of healthy vigo- 
rous men with weakly females, more especially where 
the woman is barren; but there are cases where bearing 
children does not prevent such consequences, and where 



OF THE PILES, OR HEMORRHOIDS. 349 

the increased stimulus of pregnancy upon the system 
aggravates the case. I beg that this may be particular- 
ly remembered; it is not the transient notion of my own 
imagination, but is founded on a well-grounded opinion 
of an aged physician, who justly acquired much cele- 
brity for his skill in chronick diseases. 

SECTION xv. 

Of the Piles , or Hemorrhoids. 

This is a troublesome affection about the muscles, 
which form the termination of the rectum. It has been 
called the blind piles, and the bleeding piles; the first is 
formed of one or more painful tumours, the latter has 
added to the tumours occasional, or periodical discharges 
of blood. They have also been divided into external and 
internal piles; sometimes this affection is wholly out- 
ward about the verge of the anus, at other times they 
are entirely within. But for these distinctions there is 
no good foundation: whether the disease be seated an 
inch higher, or lower, can be of no consequence. 

I think it of much more consequence, to do away th> 
ridiculous notion of the salutary nature of this discharge 
which is held by JBuchan, and others. 1 can easily be- 
lieve that where the patient has been long under the ha- 
bit of bleeding piles, it would be dangerous to check it 
suddenly; but no person should dream of inviting such a. 
crippling: on the contrary, it should be attacked witli 
spirit, and ever viewed as an enemy to the constitution. 

This affection may arise from a variety of causes, as 
costiveness, or an opposite state of the bowels; from 
drastick purges; heavy lifting; a weakly, or gross habit; 
but it seems to be more especially excited by irritation 
about the rectum, from the above enumerated and all 
other causes. Strict temperance in every thing apper- 
taining to our condition, is the most likely means to avoid, 
or remove piles. When they become painful, or' bleed 
much, it will always be advisable to use means as early 
as possible, for a little neglect now may subject you for 
life to a loathsome and painful disease. 



350 OF THE PILES, OR HEMORRHOIDS. 

Treatment. — Where it is accompanied with costive- 
ness, whether blind, or bleeding, we should open the how- 
els with mild laxatives, as sulphur and cremor tartar, 
or rhubarb and magnesia. If the bowels are laxative, 
and in a state of debility, injections of cool starch and 
water should be used; sulphur may be taken alone as a 
purgative, and at the same time a little laudanum and 
sweet spirit nitre, now and then. In full or good ha- 
bits, if piles are accompanied with very severe pain, and 
some fever, the patient should be bled once, or oftener, if 
the symptoms require it. 

It is obvious, that as piles may arise in opposite states 
of the system, we are to suit our general remedies to 
that state which is present. In full or athletick habits, 
low diet with occasional laxatives, &c. will be necessa- 
ry. In the weakly, the occasional use of the bark, elixir 
vitriol, reasonable exercise, the cold bath, &c. As a 
local application, sugar lead will generally answer every 
purpose. Persons subject occasionally to piles, should 
keep a strong liniment of sugar lead and sweet oil; and 
as soon as strong symptoms of piles occur, they should 
lay down on the back, elevate the feet and legs, and em- 
ploy an hour or two in gently rubbing the part with this 
liniment, now and then; and in the intervals, apply a 
gentle steady pressure upon the part: for want of this 
liniment, strong cold lead water will mostly answer. 
This will seldom fail to arrest outward piles, if the pa- 
tient can indulge a little for a day or two; and a relapse 
may often be prevented by applying a pledget of tow, 
and binding this up pretty firmly with a strap fastened 
to a bandage around the body; this should be worn till 
the parts recover tone. 

If the disease is internal, or attended with much 
bleeding, cold starch and water may be injected, and if 
this does not check the bleeding, or remove the pain, an 
injection of weak lead water should be thrown in, not 
exceeding in quantity a spoonful or two; and the same 
procedure should be pursued by lying down, &c. as di- 
rected for the outward affection. In these internal cases, 
we should pass a piece of ivory, or a smooth wax, or 
clean tallow candle, of a small size, up the rectum, and 



OF THE PILES, OR HEMORRHOIDS. 351 

confine it there an hour or two. If the case has pro- 
gressed for some time, and the pain has become extreme, 
whetbef tne disorder is internal or external, we must use 
emollients: in this condition of the parts, it might be 
dangerous to apply cold astringent applications; here we 
should foment the part with a bath of bitter herbs; and 
in more severe cases, a poultice of bread and milk, with 
a little camphor in it, should be applied. But these 
warm emollients are seldom or never necessary, unless 
the case has been neglected. I have had occasion in ma- 
ny cases to apply them, and suppuration has never fol- 
lowed; so that, in all cases where the cold astringents, 
With bleeding and purging, in strong habits, and mild 
glysters and gentle anodynes in weakly habits, do not 
succeed in checking the pain, we may in all cases where 
the pain is extreme, have recourse to emollients with 
safety and advantage. 

But it is a fact not generally known, that in most cases 
of blind piles, the pain arises from the violent contrac- 
tion of the sphincter' muscle of the anus. Where this 
exists, keeping some smooth substance up the rectum 
for an hour or two, now and then, will not only remove 
the pain, but wholly subdue the disease: it is always 
advisable at the same time, to use cooling washes, or 
warm fomentations, as the state of the case may require. 

There is a case on record, which occurred in this state, 
of a man v, ho had suffered the most extreme torture from 
this disease, for several months, in spite of the usual re- 
medies, applied under the direction of several respecta- 
ble physicians. An old lady at length advised twisting 
some tow pretty firmly into a long plug, and after greas- 
ing it well, it was passed up the rectum; and to the as- 
tonishment of every one, it gave instant relief, and the 
patient soon recovered. In such cases the sphincter 
muscle becomes irritable, and contracts, its surface is 
sore, this gives an increased propensity to contract, and 
the muscle, by thus forcing its tender surface together, 
produces extreme pain, and the passage becomes so clo- 
sed, that even a small glysterpipe can scarcely be intro- 
duced. 



352 OF A FISTULA IN ANO. 

All persons subject to piles, should take a little sul- 
phur now and then; should avoid sitting long at the 
cloatick vault; should occasionally use common glys- 
ters, particularly if they feel any itching or soreness 
about the seat, or are affected with ejections of a hard 
consistence. They should always, when undergoing 
fatigue, or when the disease is present, wear a firm 
smooth bandage, so as to keep up the part: this is easily 
done by a cushion of tow, confined by a strip of cotton 
cloth, made by doubling the cloth several times, and 
fastening this bandage to a handkerchief, or other ban- 
dage around the body. Lastly. A habit of this kind is 
always a sign of debility, and therefore every thing 
which may contribute to give tone and vigour, is to be 
practised; and this consists, principally, in temperance 
and regularity, of every kind. 

SECTION XVI. 

Of a Fistula in Jlno. 

This is a disagreeable and painful affection of the 
rectum and perinwiim, and consists of an opening along- 
side of the anus. It, perhaps, most commonly arises 
from neglected piles, which are suffered to run on till the 
part suppurates, and a cavity, or an opening is formed: 
into this the feces is forced, and if there is no opening 
through the perinoeum, new suppurations occur, and af- 
ter much suffering, an opening is formed, which mostly 
becomes callous in its sides, and will not heal. This 
disease seldom, perhaps never, heals without a surgical 
operation, but it is one attended with little or no danger, 
in the hands of a skilful surgeon. The best advice is ne- 
cessary in these cases, and the disease is mentioned here 
more with a view of admonishing people never to neglect 
piles, and if habitually troubled with this disease, they 
must guard against costiveness, by the frequent use of 
glysters. 

But although piles are probably often the cause of fis- 
tulous sores, I strongly suspect these fistulous sinuses 
arise from an affection which I believe has not been no- 



OF THE LAND SCURVY. 353 

ticed by any author, except Denman, who treats of it 
under the name of the ball stool; this affection is not in- 
frequent in some of our domestick animals. It proceeds 
from hardeued feces happening to lodge firmly in the 
rectum, and remaining there, the natural efforts of the 
intestines, &c. force on the feces, a small opening is 
forced, and through this the thiner part of the feces is 
strained, while the more solid part continues to accumu- 
late till much irritation arises; first from the distention, 
and secondly the feces acquire such an increase of acri- 
mony, as to unduly stimulate the parts. 

When this disease is somewhat advanced, it will some- 
times require manual assistance, with a proper instru- 
ment; but in most cases it may be prevented, and to 
those disposed to piles, this is a matter of much impor- 
tance. Therefore, in all cases where persons have to 
sit long at the cloatick vault, where there is itching, 
heat, obstinate costiveness, although there may be small 
loose stools, it behooves all such to use frequent injections. 
In every state of the body, persons of a costive habit 
should use frequent glysters; but in those troubled with 
piles, they are especially necessary; these, with every 
other attention to cleanliness, will render even those la- 
bouring under fistula, tolerably comfortable; but in all 
such cases, if a surgeon of judgment can be had, an ope- 
ration should be submitted to; as an early operation will 
seldom fail to remove the disease, and never is attended 
with danger in the hands of a surgeon of good judg- 
ment. 

SECTION XVII. 

Of the Land Scurvy. 

Scurvy is sometimes found in garrisons, with all the 
horrible train of symptoms which attend this disease at 
sea. This kind of scurvy proceeds from the same cau- 
ses, and requires the same treatment as that to which 
seamen are liable. There is another disease often met 
with, in children and others, in country families, princi- 
pally in the winter; and seems to arise from the use of 
45 



354 OF CORNS. 

too much salted meat. But owing to such persons hav- 
ing free access to pure air, partaking of exercise freely, 
and being reasonably clean; and also to their taking a 
good deal of vegetable food, the disease is generally 
very mild, and seems to be local. If it extends beyond 
the mouth, it probably, under the above circumstances, 
never goes beyond a slight affection of the stomach. 
The symptoms are spongy gums, which bleed on being 
touched with a linger or any hard body; the breath be- 
comes offensive. It is probable that cold has a share in 
the production of this complaint. 

We should dress the patient warm, but let them par- 
take freely of the fresh air and proper exercise; give 
more fresh meat and vegetables, and less salted meat. 
Let them use cremor tartar freely, in any way it can be 
most easily taken; and if the cure is obstinate, give a 
small dose of ipecacuanha every third evening, till two 
or three doses are given. If these articles should not 
purge the patient moderately, give a little senna tea. 

Another disease of the mouth is sometimes met with, 
which is supposed be of a scorbutick nature. Its symp- 
toms are spongy gums, which are apt to bleed; loose 
teeth; a fetid breath. It progresses till the teeth some- 
times are all removed. Whether we should class this 
as a variety of scurvy or scrofula, I am at a loss to say; 
but, it is known to be attended with caries of the spongy 
part of the jaw-bones, in which the teeth are set, called 
the alveolar processes. I know of no remedy for this dis- 
ease which can be applied without surgical skill, and 
therefore, I only wish to observe that cleanliness and the 
frequent use of charcoal, as a dentrifice, are all I can re- 
commend . 



SECTION XVIII. 

Of Corns. 

I have observed in a preceding part of this work, when 
speaking of the anatomy of the skin, that corns seem 
to arise from a union of the scarf with the true skin; this 
seems to be unquestionable, since cases are met with 



OF DISLOCATIONS IN GENERAL. 355 

where nerves and blood-vessels are found throughout 
their substance. It follows from this, as well as ex peri- 
ence, that, to avoid, or remove this disease, we must re- 
move all severe pressure from the part. There are cases, 
however, where, after such union of parts, the disease 
reaches through the muscles to the periosteum. The 
best remedy is bathing the part in warm water, and par- 
ing down the excrescence so far as it is devoid of feeling. 
The part may then be covered with a gum plaster, on 
very soft leather; or the expressed juice of garlick may 
be applied, and a little soft cotton laid over the toe, or 
other part affected. 



OF CASUALTIES. 



SECTION I. 

UNDER this head, I shall treat of accidents of every 
description to which we are generally liable, whether 
belonging to cases of surgery or not; a distinction into 
cases, such as require the physician, and those which re- 
quire the surgeon, can be of no use in a work of the na- 
ture of this, I proceed to speak of dislocations. 

subsection 1. 

Of Dislocations in General. 

When the articulation or connexion of the bones is 
broken up at the joint, it is called a dislocation, or luxa- 
tion, and in common language, it is said to be out of 
joint. But, little can be done by persons unacquainted 
with the structure of the parts, and in many cases, a cer- 
tain practical dexterity, will alone enable us to reduce 
or replace a luxated bone. Besides, luxations are some- 
times accompanied with compound fractures near the 
joint, which renders these cases still more difficult. 



856 OF DISLOCATION OF THE JAW; 

Luxations are sometimes incomplete, and at other 
times so sufficient a laceration of the ligaments has oc- 
curred, as to render it an easy matter to reduce, and 
therefore, in all cases where the practitioner is not to be 
had speedily; it would be advisable to endeavour to re- 
lieve the sufferer, as speedily as possible. The most 
usual dislocations are those of the jaw, the shoulder and 
wrist. Other luxations occur; but I am well persuaded, 
no benefit will arise from unskilful attempts to reduce 
them, unless they are evidently incomplete; and much 
mischief may easily be done by increasing the ir- 
ritation and swelling, which always follows, and is ag- 
gravated by every unsuccessful effort at reduction: luxa- 
tion of the neck is perhaps an exception and will be des- 
cribed. 

subsection 2. 
Of Dislocation of the Jaw* 

Some persons have the under jaw so loosely connect- 
ed, that it is thrown out frequently from gaping, &c. this 
accident also occurs from violence, as blows, falls, &c. 
To reduce it, place your thumbs firmly against the in- 
side of the jaw, and your fingers on the outside; taking 
a firm grasp, you are to pull the under jaw pretty forci- 
bly directly outward, it will generally follow a little 
way, pretty easily; at the precise moment it seems to 
halt, you are to press downward, applying the force as 
far back upon the jaw as possible, and while pressing 
downward, you are to force the jaw to that side from 
which it has receded. These motions are difficult to ex- 
press, but by a few repetitions we will find that we can 
impress a kind of three-fold motion, outward from the 
head, downward on the inner end of the jaw, making a 
fulcrum of your thumbs and fingers, and sideways by 
pressure in that direction; and all these different direc- 
tions of force, may be impressed almost simultaneously, 
or in such quick succession that they seem to operate to- 
gether. It will always be necessary to secure the thumbs, 



OP DISLOCATION OF THE SHOULDER. 357 

by lapping a handkerchief or a piece of sheep skin, 
around them. 

A luxation on both sides, is known by the chin being 
pushed forward, and downward, while the mouth is 
wide open. When but one side is luxated, the jaw is 
downward and sideways, in this case, we are only to 
change the direction of the force, putting it principally 
on the side affected. The patient must be careful in ga- 
ping, or any considerable use of the jaw for some days, 
as the part is always left much weakened and liable to 
to be thrown out. 

subsection 3. 

Of Dislocation of the Shoulder. 

In luxations of the shoulder, we are to pull the arm 
outward by taking hold of the wrist, while we set the 
foot against the arm pit, or rather below it, always pla- 
cing the foot lengthwise upon the body, so as to get into 
the hollow, formed by the muscles before and behind 
when we raise the arm; the arm is now to be raised to a 
right angle with the body, and pulled with regular force 
for some time if necessary. If this does not succeed, we 
should increase the force, and carry the hand of the pa- 
tient in various directions. If this does not succeed, let 
one person make these extensions, and after having ele- 
vated the arm, lower it gradually while another person 
pretty forcibly presses the arm upward, applying his 
force near the body, but never pressing on the portions of 
flesh which rise up on either side of the arm pit. The 
arm should be carried in a sling for a few days, and the 
part washed frequently with good vinegar, in which 
some sugar of lead is dissolved, and if much swelling 
occurs, it may be well to bleed the patient, and he should 
be abstemious in his diet. 



358 OF DISLOCATIONS OF THE WRIST. — &C. 

SUBSECTION 4. 

Of Dislocations of the Wrist. 

There is somewhat of an exception here to the general 
rule of extending the limbs, when luxations are to be 
reduced; in general, we will succeed by general exten- 
sion, while our principal force is applied inwards; the 
palms of the hand are to be applied to both edges of the 
wrist, or the sides to which the thumb and little finger 
are attached, we are then to press powerfully inwards; 
or while we grasp the wrist with all the force of one 
hand, with the other we should carry the hand upwards, 
and downwards a few times. 

But in general, most people make poor out at reducing 
dislocations, and if surgeons are to be had in reasonable 
time, any considerable efforts should not be made. — 
Some people are incredibly awkward in such matters, 
and others are too timid; and all this I speak from ex- 
perience; and can with truth add further, I have more 
than once corrected the mistakes of men long in prac- 
tice. 

SUBSECTION 5. 

Of a Dislocation of the Neclc. 

This accident seldom, if ever, proceeds from any other 
cause than falls, such as falling from an eminence, from 
a running horse, &c. A complete dislocation of the ver- 
tebrce of the neck, can never occur without producing in- 
stant death, because the spinal marrow, or elongation of 
the brain, is always injured. But cases sometimes oc- 
cur where the bones are slightly misplaced, and the pa- 
tient may easily be relieved by almost any person. 

If a person falls and lies stupified, his chin forced to- 
ward the breast, his face bloated and livid, and with the 
face turned in some measure toward one side, together 
with the loss of sense and motion, attempts should imme- 
diately be made to relieve him; and for that purpose, the 
patient should be turned on his back, the head is to be 
raised and firmly grasped, while the knees of the opera- 



OF STRAINS. 359 

tor are to be placed against the shoulders of the patient. 
The head is now to be drawn, and the force directed in 
such a manner as to straighten the neck, which will be 
done by pulling principally upon the chin, and turning 
the head to that side from which it has moved. The 
force should be gradually augmented till it is considera- 
ble, if necessary. If we succeed in time, the patient re- 
sumes breathing, as soon as the parts are replaced; and 
he ought to be bled as soon as the system has recovered 
the shock in some measure; and take a little cooling 
physick, and refrain from much exercise for a day or 
two. In these cases, if we were to wait for a surgeon, 
the patient would expire in a few minutes, and there- 
fore, we should promptly give assistance. 

SECTION II. 

Of Strains. 

Considerable strains about the joints, are sometimes 
difficultly distinguished from luxations, or even fracture 
of the condyles, or ends of some of the bones, as the 
outer ankle bones, the olecranon of the elbow, the con- 
dyles of the arm bone, &c. As these cases often end in 
stiff joints; or remain very long weak, and painful, we ! 
should endeavour to get the best advice as early as pos- 
sible. Where this is either impracticable, or the injury 
not of sufficient importance, the best application is good 
vinegar, applied either cold or warm, as the patient may 
prefer. If the inflammation runs very high, apply cold 
poultices of slippery elm, comphrey root, or milk and 
bread, with linseed. The patient should be bled, take a 
purge, drink cooling drinks, with crenior tartar; reduce the 
diet, and always rest the injured part, and keep it eleva- 
ted, particularly, if in the lower extremities or hand. 
After the inflammation and pain has began sensibly to de- 
cline, apply equal parts of vinegar and whiskey; if much 
discolouration occurs, and the swelling seems obstinate, 
add camphor to this mixture; or use volatile liniment, 
camphorated spirits, and such like. I have seen well 
marked benefit from the application of the cold slippery 
elm poultices: the manner of preparing this will be found 



360 OF FRACTURES, OR BROKEN BONES. 

in the list of preparations, but it is only suited to the in- 
flammatory stage of strains. No advice is of more im- 
portance in these cases than recommending perfect rest 
of the injured part, and never neglect any considerable 
strain; a little attention in time would save many persons 
from being crippled. 

SECTION III. 

Of Fractures, or Broken Bones. 

These call for the most skilful surgeon, and therefore 
ought never to be undertaken by others, unless absolute 
necessity render it unavoidable. I shall treat this sub- 
ject with a few general observations and directions. 

Has a compound fracture occurred, which is, where the 
flesh is wounded, and the bones either thrusted out, or 
liable to be easily forced through, much caution is to be 
observed in handling the patient. Many thoughtless peo- 
ple, the moment a person falls, no matter what injury 
they may have received, lift them hastily and rudely: such 
a procedure has often rendered fractures compound, that 
were but simple and oblique; the ends of the broken 
bone being very sharp, passes through and cuts, bruises, 
or lacerates the flesh and skin, and thereby does exten- 
sive mischief. 

Fractures are not the only cases where persons are thus 
injured who have fallen; in all such cases we should care- 
fully examine the patient, and content ourselves by first 
gently turning the patient on his back, carefully observ- 
ing, even here, whether all the limbs follow, if we have 
any suspicions of fracture. Let the head be gently rais- 
ed, and fan the patient with your hat, if necessary; and 
if means are at command, such remedies as are recom- 
mended for fainting or swooning, are to be applied. 

When the patient revives, carefully examine his limbs, 
whether any fracture exists, before you attempt to raise 
him. If there is a fracture, the patient should remain 
where he is, till the easiest carriage can be obtained to re- 
move him; and if cold or wet weather does not forbid, the 
surgeon should be taken to the spot; and the patient 
dressed before he is moved. 



OF FRACTURES, OR BROKEN BONES. 361 

If no surgeon is to be had, the limb should be secured, 
if a leg, by applying a pillow, and outside of this, a 
strong splint on either side; this should be tied with wool- 
len strings, firmly, but not too tight. When the patient 
has been carried to a suitable place, the limb is to be 
washed with vinegar; but if there be deep holes, as most- 
ly happens in compound fractures, we should carefully 
stop them with lint, and prevent the vinegar from getting 
in, otherwise it may do much mischief. 

We are now to take a pillow, spread on it, first, strips 
of strong muslin or fine flannel, ahout two inches wide, 
or rather less, and long enough to go round the limb af- 
ter the splints are applied; these strips are to be spread 
so as to lap over each other nearly one half, and from 
one end of the limb to the other; that is, in the leg, we 
should carry them from the foot to the top of the knee 
joint; and in the thigh, from the knee to the groin, and if 
the fracture be oblique, we should carry the splints, &c. 
to the foot. On these, we are to lay two strong splints 
of shingle, or thin board, one for the inner, and one for 
the outside, and a flexible one in the middle, made of 
green wood, to lay immediately under the limb; these 
splints are to be the length of the limb, or as long as the 
layer of strips, and well lapped with soft tow; on these 
again we are to spread a clean soft piece of old muslin, 
or linen, large enough to lap up the whole limb. The 
pillow thus furnished is to be laid under by one person, 
while a second gently raises the limb; the lapping cloth 
is now to be smoothly applied; on this, the splints; all 
spaces between the splints and limb, are now to be filled 
with tow or cotton, and while they are held in place by 
one person, another begins at that end of the limb where 
the last strip was laid, and laps them over one by one, 
and when the whole are evenly applied, a few pins must 
be put in where they overlap, to prevent their opening. 
The whole is now to be wet with vinegar, and kept wet: 
these dressings should be changed once in two, four, or 
six days, accordingly as the weather is warm, or the skin 
open. The patient may lie on the back, or either side, 
provided the limb is carefully adjusted to the position of 
the body. 

46 



36$ OF FRACTURES, OR BROKEN BONE&. 

In fractures of the arm, we are to proceed nearly in the 
same manner; but unless the fracture be very near the 
joint, we may put it into a sling, taking care in all frac- 
tures of the forearm, or about the elbow joint, to secure 
the fingers from all motion, by carrying the splints and 
bandages out over them. 

In severe fractures it will always be necessary to bleed 
once or twice; take a little cooling physick, and live ab- 
stemiously, except there be considerable debility of habit, 
or in patients accustomed to high living. But even such 
persons will be benefited by a reduction of their diet, 
taking care not to continue it so long as would be neces- 
sary for those of better constitutions and habits. In de- 
praved habits, as soon as the inflammatory symptoms be- 
gin to subside, which will generally be from five to seven 
or eight days, the bark and port wine should be given 
with some freedom. If mortification threatens, which 
seldom, if ever, occurs in good habits, without misma- 
nagement, but is always to be dreaded in depraved habits; 
and more especially where there has been considerable 
lacerations, we are to examine the limb every day, par- 
ticularly if there be much fever, or pain and heat in the 
limb. If the part weeps out thin bloody matter, feels 
flabby about the edges, has much ill, or dark-looking flesh, 
and more especially if the limb begins to blister, exhibit- 
ing small blisters for some distance around, we should 
apply a blistering plaster, reaching all round the limb, 
and a good distance above and below the sore, having a 
hole the size of the sore; and over this part we are to lay 
the carrot poultice; and after the blister is removed, we 
should extend the poultice over the limb, as far as the 
blistering plaster has acted, or as far as those of the gan- 
grene extend. At the same time the bark must be taken, 
with elixir vitriol, snakeroot tea, or vinegar, &c. as the 
case may be supposed more or less inflammatory. , 

And it may be remembered, that the bark will avail no- 
thing in mortification, unless it be taken largely, as two to 
four ounces in twenty-four hours. Let it also be remem- 
bered, that these instructions are given for cases of abso- 
lute necessity, and that fractures always call for the utmost 
skill and attention, and there are even but few practition- 



OF WOUNDS. 363 

ers, who are really competent to manage them: how much 
less then are we to trust these cases to the ignorant in 
those matters. 

In all places, officious persons are found , who are not 
only willing, but anxious to be employed in such mat- 
ters; such conduct is sometimes highly reprehensible, and 
never justifiable unless necessity requires it, when it be- 
comes a duty, and is sometimes attended with success, 
as I have seen. But I am compelled to observe, that in 
general, I have found those most officious in these mat- 
ters, least calculated to manage them, and woful mischief 
often follows. Nay, more, I have seen ignorance itself 
endeavouring to direct the skilful surgeon, who with all 
tenderness was applying the proper means, so that upon 
the whole, I think the best advice I can give in cases of 
this kind, is, for those who are anxious or willing to act, 
simply this: select the best horse you have^ or can get, 
and go with all speed for a skilful practitioner, and you 
will seldom do any mischief, barring accidents which may 
befall the inconsiderate rider. 

SECTION IV. 

Of Wounds. 

SUBSECTION 1. 

Of Cases which heal by the first Intention. 

From the earliest ages of mankind, mistaken views 
have prevailed, respecting the healing powers of many ar- 
ticles. Every nation, surgeon, or old woman, possesses 
some wonderful healing nostrum, and from the variety of 
discordant things employed, we have well grounded as- 
surance, that some of those supposed remedies are inert, 
some of them slightly unfriendly, others highly injurious. 
It seems as if the human mind was ever more subject to 
embrace, and perpetuate errour, than to discover truth, or 
correct views of subjects, until corrected by long suffer- 
ing. I am led to these reflections from the unaccountable 
circumstance, that from time immemorial mankind have 



364? op wounds* 

looked up to the natural operations of the body, for thfr 
cure of their internal, or hidden diseases, while in those 
obvious to our senses, because superficially situated, 
they attribute little or nothing to the natural healing 
powers. 

And yet, the united judgment of many men of experi- 
ence and discernment, has long since discovered, that the 
reverse is much nearer the truth; that is, while the natu- 
ral powers are seldom to be trusted in internal diseases, 
in wounds or superficial diseases, these natural powers 
are alone to be depended on. 

It may not be amiss to state a few positions in favour 
of the opinion, that we are to expect more from the natu- 
ral operations in external, than in the internal diseases, 
with which mankind are afflicted. In the present state 
of society, all our diseases are in great measure artifi- 
cial, or perhaps more correctly speaking, they are the off- 
spring of vicious, or improper habits, and as they are 
brought on us by warring with, or trampling on the natu- 
ral healthy operations, we cannot even hope that like the 
licking cur, nature will kiss the hand of the assassin, or 
unthinking persecutor. He who is an enemy to himself, 
must be an enemy to the anima medica; and while expe- 
rience proves beyond a doubt that nature is punctilious, 
yet kind to those who tread with becoming fidelity, and 
pleasantry in her sober but delicious paths, the same ex- 
perience teaches us s that she will meet her enemy face to 
face, or hand to hand, and while she whips the culprit with 
his own weapon, with her right hand she points to the 
grave, and with weeping eyes, the left quivers on the 
beam, unwilling to give the preponderating stroke, till 
heart broken with anguish and despair, with closed eyes 
the tremulous stroke is given, and disease or death mounts 
the scale. But she is not inexorable, but often relenting 
she lends her aid, in banishing disease from the body; not 
often, however, till she has obtained promises of amend- 
ment, from the sufferer. 

I have elsewhere endeavoured to prove that nature ei- 
ther cannot, or will not cure our diseases, I therefore pro- 
ceed to state some opposite positions, why we may rea» 
sonably look up to nature for aid in our superficial dis- 



OF WOUNDS. 365 

eases or wounds. In all situations and conditions of life, 
mankind are liable to casualties, and therefore, it has been 
kindly and wisely provided, that the natural powers shall 
restore in a reasonable degree, the various breaches made 
on our bodies; and although the surgeon must often aid 
by taking up bleeding arteries, removing unsound bone, 
or mangled limbs, yet, the healing process is wholly de^ 
pendant on nature. If we find these healing powers, 
slow at times, at others we are equally astonished at the 
vast and important repairs, which she accomplishes in 
a short time; and it will often be found, that the most 
tardy cures are owing to disease, lurking or manifest 
within. 

Upon the whole, I am supported by innumerable facts, 
and the concurring experience of many discerning men, 
that in disease we are ever to watch nature carefully, and 
never trust wholly to her operations; while in wounds or 
external Icesions, we can do nothing more than defend 
the parts by suitable warmth or moisture, and by proper 
means, guard against irritation, by suitable bandages, or 
dressings; but to dream of adding one particle towards 
the restoration, by outward applications, is truly pre- 
posterous. 

But although nature may emphatically be styled the 
physician in these cases, we can promote her intentions by 
suitable means, founded en experience, and on science: 
to point out these indications and means, shall be the se- 
quel of this section. 

Nature has two modes of healing wounds, first by an 
immediate union of vessel to vessel, fibre to fibre, or par- 
ticle to particle, this is called healing by the first intention. 
The second mode she employs in more violent injuries, 
and here she accomplishes her purpose, by suppuration 
or secreting a healthy matter or pus, designed to defend 
and support the arteries, and nerves, in their architectural 
functions. These modes being opposite in their nature, 
it follows that we are to vary our applications, or we may 
Materially thwart her designs. In judging of the proba- 
bility of a wound's healing by the first iutention, we are 
to bear in mind, that superficial clean cuts, or those which 
run lengthwise on the limb, or those which merely'split 



366 9F Wounds. 

the muscular fibres, those which have not been exposed 
too long to the air, and accompanied with the circum- 
stance of a healthy body, are most likely to heal by the 
first intention. And in all these cases, if we are well sa- 
tisfied nothing extraneous lies within, we ought not even 
to wet the part: all applications of spirits, tinctures, bal- 
sams, or washes, are at least unnecessary, and often high- 
ly injurious: the best method is simply to bring the part 
into contact, first removing clotted blood with a clean fin- 
ger, or by means of a small stick lapped with soft lea- 
ther; then with adhesive strips or sticking plaster of suf- 
ficient length, secure the edges of the wound well toge- 
ther, and over this lay a soft compress, and secure this 
by means of a roller passed several times round the 
limb. 

If things go on well, in three or four days the dress- 
ings may be removed, and it will now be advisable to 
wash the part clean and apply a little mild ointment, and 
renew the roller. But if the pain increase to violence, 
and particularly if the wound is considerable, or the ha- 
bit bad, we may expect suppuration, or even mortifica- 
tion may occur, and, therefore, the part should be un- 
done, and if necessary, treat the case as detailed in this 
section for wounds, which do not heal by the first in- 
tention. 

We are also to remark, that in most cases of incised 
wounds or cuts, though across the muscles, much benefit 
will arise from a few stitches in the part to keep them in 
contact, and they will mostly, at least in good habits, heal 
in great part by the first intention; and sometimes entire- 
ly. But we are to remember that such wounds must 
have ceased to bleed furiously, that all extraneous bodies 
are to be removed, in the most tender manner, before we 
proceed to sew up; in doing which we must have a crook- 
ed needle, that we may reach to the bottom of the wound, 
and large enough to carry a strong flaxen thread; the nee- 
dle should be entered a considerable distance from the 
edge, otherwise the threads will soon cut out, and unless 
we carry the needle to the bottom there will be a cavity 
left, where collections of matter will form, and which, 
if considerable, must ever find its way out through the 



OF WOUNDS. 367 

wound, or it may descend among the muscles, and pro- 
duce serious consequences. 

subsection 2. 
Of Cases which should suppurate. 

In cases where there is considerable lacerations, or loss 
of substance, we must pursue such measures as will pro- 
mote suppuration, or in other words we should keep the 
part clean, warm and moist, that nature may not be hin- 
dered by the irritation, which would arise from unclean- 
ness, extraneous bodies, or the contact of cool air in ac- 
complishing her secretion of bland pus, to cover the 
tender parts, which are to be formed by the arteries and 
nerves. To answer these intentions, we should first co- 
ver such wounds with lint, spread with the mildest oint- 
ment, and as soon as any considerable pain or soreness 
of the part supervene, we should apply warm poultices 
of bread and milk, or common Indian mush; and unless 
there be considerable cavities, we may apply the poultice 
immediately to the sore; but if there are cavities running 
in various directions, we are to put in a little very soft 
clean lint, spread with mild ointment; and the poultice 
should be greased with a little nice oil, or fresh lard. At 
every renewal of the poultice, which should be three 
times in twenty-four hours, the part should be well 
washed with milk and water, warmed a little, and in 
three or four days we are to use mild soapsuds for this 
purpose; remembering always to remove all old lint or 
pieces of poultice, which may adhere to the sore, but in 
doing this, we are by no means to use any violence. If 
things progress well, we should continue this course from 
ten to fifteen days, according to circumstances, and then 
the common basilicon, mixed with a little spirit turpen- 
tine, should be applied twice a day; never forgetting that 
in all sores it is of the utmost importance to keep not only 
the sore clean, but the skin around, or rather the whole 
limb. 

In addition to these external remedies, we arc to pay 
the most scrupulous attention to the general system, m 



368 OF WOUNDS. 

all considerable wounds. From the commencement, the 
patient should be put on a very low diet, refraining, if of 
good habit of body, from spirits, animal food, or even 
broth, or much fats. The mildest drinks of milk and 
water, slippery elm, toast water, apple, or barley, water, 
and such like. The bowels must be kept open by using 
creraor tartar, mild glysters, or mild physick, if necessary, 
and from the commencement, the use of full anodynes at 
night should be advised: and if fever supervene, we 
must bleed, and repeat, according to the violence or ob- 
stinacy of the case. The above means carefully applied, 
will generally answer our wishes. But unpleasant or 
dangerous consequences sometimes supervene, notwith- 
standing all our efforts. These are, first, mortification; 
if the sore does not matter well, but discharges a thin or 
brownish fluid, with considerable heat in the part, looks 
foul and ill-coloured, we are to pay close attention, lest 
mortification progress before we are aware of it. If to 
the above appearances are added blisters around the 
sore, with considerable chills and flashes of heat, gan- 
grene or incipient mortification is at hand, and the treat- 
ment must be changed: the part is still to be fomented 
well with mild soapsuds, and the carrot poultice ap- 
plied, and renewed every two or three hours: for the 
treatment in these cases, see the article mortification. 

If locked jaw or tetanus arise from wounds, see the 
article on tetanus. 

subsection 3. 

Of Wounds which bleed, or are like to bleed, danger- 
ously. 

It ought to be borne in mind, by every man, that, in 
many cases of wounds, life may be lost in a few minutes 
for want of stopping bleeding from a wounded arte- 
ry. By early attention to wounds of the limbs, which 
bleed furiously, a companion, or the patient himself, may 
often save life, till a surgeon is called to secure the 
bleeding vessel. For this purpose, in all wounds which 
bleed dangerously, a ligature or strong string should be 



OF WOUNDS. 369 

passed around the limb, and always between the wound 
and the body; this is to be tied so as to leave room for 
running a stick into the loop, and then, by turning round 
the stick, you are to twist the ligature so tight as to stop 
the bleeding. For want of a stick, a strong man can 
sometimes draw the knot sufficiently tight; or after tying 
the string tight, it may be rendered still more tight by 
stuffing in a waistcoat, or the like. A handkerchief will 
answer for the ligature, and where this is not at hand, 
tear a strong strip from your shirt. Many a life has 
been lost for want of attention to such means. 

In deep wounds, as gunshot, from the sword, or 
other instruments which enter the flesh any considerable 
distance, another consequence is to be apprehended still 
more alarming than those enumerated above: if the in- 
jury has happened near to, or perhaps slightly injured a 
large artery? as those of the arm or leg and thigh, there 
always is danger of the artery being opened, by the 
slough which has to come away, and the period at 
which this will happen, is very uncertain; it may occur 
at any time from the accident, to the third week; in 
general, the term of two or three weeks is most dan- 
gerous. 

Upon the whole, it plainly appears that much skill 
and prudence is necessary in all considerable wounds, 
and therefore experienced practitioners ought alone to 
be trusted. It may be remarked here, that mortification, 
as well as traumatick tetanus, mostly proceeds from too 
high inflammation; and, therefore, in mortification from 
wounds in good habits, we are by no means to stimulate 
by wine, bark, or any, other articles; the indications 
here, are to lessen action by a more frequent repetition 
of the fomentations and poultices, and that of slippery 
elm is particularly proper; by bleeding from the arm, 
applying leeches, or scarifications and cups about the 
part; and if gangrene occurs, blisters should be applied 
entirely around the limb, above and below the wound, 
but leaving the lacerated parts open for the application 
of the carrot poultice. But if the habit be bad, or if a 
sickly season exists and diseases partake of a low grade, 
we must be extremely cautious in the use of evacuations, 
47 



Jr..* 
S70 OF BRUTSES. 

and if kindly suppuration does not occur by the fourth or 
fifth day, use the carrot poultice; give the bark with 
elixir vitriol, or with wine, snakeroot tea, or milk, ac- 
cording to circumstances; and give the patient for diet, 
a little rich panada, broth, or light animal food, coffee, 
and such like: take especial care to give but sparingly 
of any kind of food for a few days. For more particu- 
lar instructions, see mortification. 

subsection 4. 
Of Bruises. 

Under this head some very formidable accidents may 
be placed, occasioned by falls, blows, or from a person 
being run over by a carriage, a horse, &c. In all con- 
siderable bruises we are to expect considerable fiper, 
and unless it is subdued, suppuration or mortification may 
supervene: severe pain, throbbing or beating in the 
part, with general chills and heats, are always unfa- 
vourable. 

To bruises on the limbs we should apply slippery elm 
bark, moistened with good vinegar, or several folds of 
muslin or linen wet with vinegar, in which a little sal. 
ammoniack or sugar lead is dissolved; these are to be 
renewed every two or three hours; the patient must be 
bled, and the operation repeated daily till the fever and 
chills abate; cooling purges, as rochelle salts, senna and 
cremor tartar, or a free use of cremor tartar water. The 
lowest possible diet, and mild cooling drinks. As soon 
as the inflammatory symptoms abate considerably, or in 
cases where these do not occur by the fifth, seventh, or 
tenth day, according to circumstances, we must change 
the outward applications: whiskey and vinegar, volatile 
liniment, camphorated spirits, or opodeldock, or some of 
the patent articles may be applied, as British oil, Colum- 
bian oil, &c; but it should be made an invariable rule 
to wash those articles clean off with soapsuds, once a 
day. These directions apply to persons in good habits 
and health. When these accidents occur in bad habits, 
or very delicate habits, or in sickly seasons, we are to 



OF BRUISES. , 371 

deplete with great caution, and often not at all; we are 
to apply stimulants outwardly from the commencement, 
as poultices containing camphor, or with British, sene- 
ka, or other stimulant oils, spread over them: repeat 
these twice a day, aud wash the skin clean once a day 
with soap; the bowels are to be kept open, but purging 
is to be avoided'; laudanum should betaken every even- 
ing. The diet must be light, but reasonably nourish- 
ing, and a little good wine, or weak punch may be 
taken. Snakeroot tea, a little bark, or elixir vitriol, 
ought to be used. 

In considerable bruises of the abdomen, or chest, we 
are generally to bleed with great freedom; open the bow- 
els with mild injections, and if vomiting occurs, give 
opiates with freedom: the utmost quietness and ease ie 
necessary, and thin weak diet is only to be allowed, 
with the mildest cooling drinks. 

In good habits, the less nourishment is taken the bet- 
ter for the first five or six days; and, I have often seen 
marked advantages from living on a little toasted bread 
soaked in water, with cooling drinks. I know of no 
cases which so invariably call for the use of the lancet: 
in strong athletick persons, we must bleed largely and 
freely, and eyen iu the most delicate, a few small bleed- 
ings are indispensable; but we must be cautious in in- 
temperate., or depraved habits, not to continue to bleed 
too long. Opiates, aud open bowels are never to be 
overlooked; but there cases often call for the greatest 
skill, and therefore competent practitioners are alone to 
be trusted. 

Bruises, or blows on the head, attended with 
stupor or violent pain, generally require bleeding, and 
also the free use of stimulant, or purging glysters, with 
low diet and cooling drinks; mild purges are sometimes 
necessary. 

But if a person be suddenly knocked down, and lies 
stunned or insensible, we are by no means hastily to 
draw blood, a too frequent custom; but we ought, merely, 
to turn the patient on his back, and raise the head a lit- 
tle; a free circulation of air is necessary; a liftle water, or 
wine, or toddy, may be given; and if obtainable, a glyster 



372 OF RUPTURES, OF HERNliE. 

must be administered. A practitioner should be called 
in, but if none is at hand, in a reasonable time, we should 
venture to bleed as soon as the pulse is found active: if 
the pulse do not rise, it will always be safest to omit 
bleeding, and give repeated glysters, and a little wine 
and water, or five or ten drops of spirits of hartshorn in 
water, may be given. 

Under these circumstances the skilful surgeon will 
often find it expedient to bleed, but I am confident I give 
a well grounded and correct opinion, when I say vast 
mischief is done in those, and many other cases, by the 
precipitate use of the lancet, by unskilful persons. Let 
no one infer from these remarks, that I am opposed to 
bleeding in these cases, we generally find it absolutely 
necessary, and without it, perhaps, few persons would 
recover from very considerable injuries done within the 
head. But it was long ago remarked by Solomon, that 
there is a time for every thing under the sun; and to 
bleed too soon, before the system has recovered the 
shock, is geuerally bleeding out of time, and whatever 
is not well timed, is wrongly applied. Therefore, 
never be too much in a hurry about bleeding, a few 
hours, or even a day or two in some cases, are neces- 
sary for the reaction of the system to bring the body to 
the bleeding point. 

Lastly, if no skilful person is to be had, and the pulse 
does not rise in a reasonable time, we must bleed, or 
reaction may never occur, and the patient might be lost 
for want of unlocking the blood vessels. 

section v. 
Of Ruptures, or Hernice. 

Ruptures, or a protrusion of the intestines, omentum* 
peritoneum, &c. occur in various parts of the abdomen, 
and pelvis: these ruptures are called hernice, and occur 
most frequently in the groin, thigh, navel, and some- 
times through the layers of the abdominal muscles, in 
various parts. They are sometimes congenital; some 
occur, without any known cause, at every period of life: 



©F RUPTURES, OR HERNIjE. 373 

and often they proceed from violence, done by straining, 
lifting, &c. They are known to exist in many persons 
for long periods without any particular injury, but all 
such persons are invalids, and liable to suffer much; 
besides running extreme hazard from trifling causes, as 
slight injuries done the part; from the parts taking on 
inflammation and swelling, by which the gut, or other 
parts protruded, becomes strangulated, that is, the open- 
ing closes, and pinches or confines so as to check the 
circulation; and this soon leads to mortification. 

In young persons, these openings often heal, if the 
patient wears for a sufficient length of time a truss, 
well adapted to the part; and in those more advanced 
in life, trusses ought always to be worn, for, besides the 
greater security obtained by keeping the parts within, 
there is much less risk of its being violently thrust out 
from lifting, &c. 

These trusses are always to be had by applying at 
the apothecaries,* or by consulting country physicians. 
Persons affected with ruptures should carefully guard 
against costiveuess, and while they pursue active exer- 
cise, in order to maintain a due strength of muscular 
fibre, they are most scrupulously to avoid straining, or 
heavy lifts. 

If a rupture at the groin, or elsewhere, becomes stran- 
gulated, as manifested by extreme pain, colick, costive- 
ness, sickness and vomiting, all possible speed is to be 
made in returning the part into the abdomen. This is 
first to be attempted by the person lying down and en- 
deavouring to push up the part; if he does not succeed 
by reasonable efforts, cold water should be poured upon 
the part; mild injections should be used to empty the 
bowels; the attempts at reduction are now to be renew- 
ed; if these do not succeed, we should, in good habits, 
bleed till some symptoms of fainting occur, when the 
attempts are to be repeated: all this failing, injections 
of tobacco, or the smoke of it should be thrown up the 
bowels. These remedies are to be used without loss of 

* A truss lias lately been imported from England, of a superiour 
construction to any I have seen. They are known by the name 
of Wright's patent "truss. 



374 OF BURNS, AND SCALDS. 

time, and if ineffectual, a surgeon is to be called in, who, 
by a timely operation, can often save life; or who, by 
bis superiour judgment, may think it safe to continue the 
means for reduction sometime longer. 

In attempting reduction in general, if the patient is at 
years of maturity, he should reduce it himself: most 
persons are very heavy fingered, and awkwaea in hand- 
ling such things, and may easily do dreadful mischief, by 
hastening mortification, which is always to be feared in 
these cases, and should induce us to be speedy in get- 
ting the best assistance. 

Large quantities of warm water thrown up the intes- 
tines, is sometimes useful, aud may always )je tried be- 
fore using the disagreeable remedy of tobacco smoke. 

After the reduction, it will always be advisable to 
take an anodyne or two, to keep the bowels open with 
mild glysiers, aud avoid all solid food: these precautions, 
with reasonable rest, are of vast importance to those who 
have been severely affected with this dangerous kind of 
affliction. 



SECTION VI. 

Of Burns, and Scalds. 

For slight burns or scalds, the immediate application of 
clean, soft carded cotton is a good application; or if this 
is not at hand, equal parts of turpentine and sweet oil, or 
weak brandy, should be applied, and for want of all these, 
slippery elm bark, simply wet with cold water, or scra- 
ped potato. But if the burn is deep, we should apply 
warm milk and water, till we can get spirit turpentine 
and sweet oil; or lime water and oil; or linseed oil, fresh 
and cold drawn, mixed with lime water. The patient 
should take a full dose of laudanum, and this is to be 
repeated till chilness abates, which always attends large 
burns. 

If, on examination at a second or third dressing, we 
discover that the true skin is destroyed, and will of course 
slough off, we should apply a mild poultice of bread and 
milk, and repeat them every three hours till the parts sup- 



OF BURNS, AND SCALDS. 375 

purate freely, and pain and fever abate: when these ap- 
pearances of suppuration are well marked, we may re- 
move the poultice, and dress the sore with basilicon, con- 
taining some spirit of turpentine; if this should cause 
any pain, which is seldom the case, it must be removed, 
and Turner's cerate, or other mild ointments applied. In 
cases tolerably severe, we will in general succeed well by 
using the sweet oil and spirit turpentine, three times a 
day, and covering the sore in the intervals with soft lint, 
or old mustia spread with the basilicon and spirit of tur- 
pentine; or by simply applying, very frequently, linseed 
oil and lime water; but in all cases it will be well to wash 
the parts well with milk and water for a few days, and 
afterwards with mild soapsuds once a day. 

In bad habits, or where cases have been improperly 
treated, this kind of inflammation, like all others, is lia- 
ble to terminate in mortification: if the sore continues 
painful and ill looking, and especially if blisters rise af- 
ter the second or third day, we are to be cautious how 
we proceed; and, for instruction in such cases, see the 
article on mortification. In all extensive burns we are 
carefully to watch the health of the patient; they should 
live low, drink nothing but mild cooling drinks; take a 
cooling purge now T and then; and if much fever super- 
-vene, bleeding, repeated according to the severity or 
continuance of the fever, will be necessary. 

But where there is reason to apprehend mortification 
from a bad habit of body, a more generous diet will be 
advisable, consisting in part of broth, light animal food; 
and a little good wine or punch may be allowed; and 
the bark and elixir vitriol, &c. must be taken; but for 
instructions on this form or grade of inflammation, from 
whatever cause, see the article on mortification. 

Since the publication of the first edition of this work, 
a very alarming accident occurred in my family. A child 
of two years fell backwards into a tub of water and clothes 
nearly boiling hot; the clothes prevented him from sink- 
ing deep, but the whole of his back, hips, &c. to the ex- 
tent of nearly a foot, in every direction, was severely 
scalded, and of a most fiery red; his pain was extreme. 
I had seen many similar accidents, and, had no doubt but 



376 OF FROST BITES. 

the whole would blister and throw off the scarf skin; 
but, fortunately I had a bottle of spirits of turpentine in 
which some white wax was dissolved, this was applied 
freely in less perhaps than one minute: after bathing the 
part for some minutes with this, soft cotton was laid on, 
and secured with a handkerchief. The child slept in a 
few minutes, and enjoyed it for two hours; he then arose 
and made no complaint. The part was opened in a few 
hours; and to my great surprize the whole had termina- 
ted in a few small blisters. The same dressings were con- 
tinued till next day, when the whole was thrown off. I 
have no doubt but "if this case had been otherwise treat- 
ed, or if there had been any delay in the application, 
the whole would have blistered; and as these accidents 
occur frequently, every family should always keep those 
articles ready. 

SECTION VII. 

Of Frost Bites. 

In treating on these accidents, I shall first speak of the 
means necessary to secure against their occurrence, and 
then conclude with some instructions for those thus un- 
fortunately situated. 

Persons who are about to travel in severe cold weather, 
should never drink any considerable quantity of spirits, 
as is geuerally practised, for spirituous drink not only is 
very transient in its stimulant effects, but always leaves 
the\ystem lowered in its excitement, when it has ex- 
pended its force, and this is more particularly the case 
in intense cold, which in a peculiar manner, seems to 
destroy the stimulant powers of ardent spirit. Neither 
should they eat a full meal just before setting out; per- 
sons of observation must be aware, that chilness almost 
invariahly succeeds a large meal, even of animal food. 
The first consideration is to provide suitable warm clothes, 
and particularly to guard the feet: it may be said every 
person is sufficiently aware of this, but I beg leave to 
observe, many persons are found thoughtless enough to 



OF FROST BITES. 377 

despise cold, and sometimes suffer either severe frost- 
biles, or other disorders, and even death. 

In this country, people seldom suffer death from in- 
tense cold, unless intoxication prepares the system for this 
cold, but fatal stroke. It may be remembered, that much 
advantage may be gained by those who are about to travel 
on foot, by taking care not to encumber themselves with 
heavy great coats, or heavy clumsy shoes; mokasins, or 
cloth shoes soaled with a piece of an old hat, is vastly 
warmer than the thickest leather shoes; instead of one or 
more heavy long coats, which are often worn, it will al- 
ways be better to put on two or three pair of pantaloons, 
as many shirts and waistcoats. Every person, perhaps, 
knows the fatal tendency of sleep, which presses on the 
benumbed traveller, but every one may not be aware of 
the irresistible power it has over the most manly spirit: 
instances are on record of persons remarkable for good 
sense, and accustomed to travelling, and cold, being so 
overcome that they were anxious to enjoy this fatal sleep, 
although well aware of its nature. 

In addition to the things prescribed above, for dress- 
ing, I would recommend to such travellers always to 
let digestion progress half an hour, or a little more, be- 
fore they venture on their journey, after taking a nou- 
rishing meal, and this is always necessary; some solid 
article of food should be taken along, as gingerbread, a 
little crust of bread and cold meat, or a little whole mus- 
tard seed may be taken now and then. 

When any part of the body is frostbitten, hold the part 
a few minutes in cold water, this, or gently rubbing the 
part with snow is the only safe remedy: to go into a warm 
room without a careful application of this remedy, would 
be certain ruin, the part will invariably mortify, and if 
the frost has penetrated deep, fever and death may fol- 
low. The patient must keep from the fire until the pain 
ceases; if able he should walk about until relieved, if too 
much exhausted, he should be constantly rubbed with a 
cold wet hand, until the pain ceases. If the patient is 
languid, a little warm tea, or a little panada, or broth, 
shouid be taken: should inflammation or ulceration fol- 
48 



-378 OF DRINKING COLD WATER, &X 

low, the case must be treated as inflammation or ulcers, 
from other causes. 

Should persons be found apparently dead from cold, 
I would advise, in preference to any other means, to se- 
lect a sunshiny situation, as free from cold wind as may 
be, and there bury the body with the clothes on, with 
snow, and await the issue, or if attainable a little warm 
tea, or warm wine and water, should be given. If this 
is not attainable, carry the body carefully, that is, gently 
and without suffering any of the limbs to hang down, 
into a cold room, and there rub thein gently with snow; 
or they may be dipped once or twice into cold spring 
water, and then lapped up in cold clothes, first a single 
cold sheet, then another, then a blanket, and thus leave 
the body. 

It will be obvious, that the room must not be as low 
as a freezing temperature, but it must be quite cool; and 
in the application of clothes to the body, we are not to 
be in too much hurry; if a blanket is applied too soon 
it may have a bad effect. For the treatment of slight 
frost bites in the hands and feet, see the articles kibes, 
and chilblains. 

SECTION VIII. 

Of the Disorder arising from drinking Cold Water, £fc. 

It is to be remembered, that other cold liquids arc 
equally dangerous, when taken under the following cir- 
cumstances: 

1. When the body is much heated. 

2. The liquid very cold, and 

3. When taken in large quantity, and it has been 
correctly observed, by Dr. Rush, that the danger is pro- 
portioned to the amount in combination, of all these cir- 
cumstances. 

I shall first give a few cautions for its avoidance, and 
then describe the symptoms of the disorder, and point 
out its cure. Before proceeding to these details, I think 
proper to admonish the reader, that if such dreadful and 
immediate consequences follow the rash drinking of cold 



OF DRINKING COLD WATER, &C. 379 

liquids, we cannot doubt for one moment, but that many 
bad consequences do follow such practices, and which 
are less known because less evident, but -often more fa- 
tal, because more slow and hidden in their operations. 
And, therefore, while we rejoice with the amiable and 
illustrious Rush, that this disease is nearly banished from 
Philadelphia, by the humane and skilful attention of 
scientifick men, we should carefully remember that, by 
an improper use of cold liquids, too early in the day, or 
when too warm, from exercise, we may suffer seriously, 
and attribute it to some other cause. Among these, we 
are to reckon, cold punch, cold water, mineral water,* 
ice creams, &c. all these, when the body is too warm, 
produce extensive mischief: consumptions, cholera mor- 
bus, colick, fevers, palpitations, dyspepsia, gout of the 
stomach, and many other diseases proceed from the 
abuse of these articles. 

Preventives: early rising which will enable you to 
get through your business, and allow a sufficient time to 
rest in the heat of the day; using mild bland food, and a 
reasonable quantity of good ripe fruit, will, in good mea- 
sure, do away any ungovernable desire for these articles: 
and to pour them down without desire is servile, and 
base: if it is done from artificial taste, or with a view of 
amusing the palate, it is brutish; and after all, the brute 
in this respect is your superiour, for while they enjoy 
their regular appetites undiminished, the fickle palate of 
man, as if on purpose to befriend, soon loses all keen 
zest, and it is a fact, that the epicure enjoys of all other 
creatures upon earth, least pleasure from the taste: it 
often becomes a very curse, and while he racks every 
energy to procure new relations between his taste and 
aliment, each in its turn becomes offensive. A reasona- 
ble use of those cold articles is not particularly unfriend- 
ly, but we should ever bear in mind, the three circum- 
stances which render them particularly dangerous, and 
which have been mentioned in this section. These are 

* Of all these articles, water impregnated with fixed air, (carbon- 
ick acid,) is the safest, but, it may be misused, either by taking it 
too early in the day, too much of it, or too cold when the body is 
much heated. 



880 OF DRINKING COLD WATER, &C. 

a heated body, very cold articles, and lastly, taking them 
in considerable quantity. 

In drinking cold water when we are much heated, we 
should rinse the mouth, or wash the hands or face: or 
simply holding a vessel in the hands, and taking a sip 
or two before we swallow much water, will obviate the 
danger; and it may be well to consider, that we often 
allay thirst better by small repeated drinks, than large 
draughts of cold water, which are never necessary, and 
are only indulged in by the hasty or inconsiderate. 

If a person is found who has injured himself materi- 
ally hi this way, the following symptoms are said by Dr. 
Rush to follow, 'fm a few minutes .after the patient has 
swallowed the water, he is affected by a dimness of 
sight; he staggers in attempting to walk, and unless 
supported falls to the ground; he breathes with difficul- 
ty; and a rattling is heard in his throat; his nostrils and 
cheeks expand, and contract in every act of respiration, 
his face appears suffused with blood, and of a livid 
colour; his extremities become cold, and his pulse im- 
perceptible; and, unless relief be speedily obtained, the 
disease terminates in death, in four or five minutes." 

"This description includes only the common cases of 
the effects of drinking a large quantity of cold water, 
when the body is preternaturally heated. More fre- 
quently, patients are seized with acute spasms in the 
breast or stomach. These spasms are so painful as to 
produce syncope, and even asphyxia. They are some- 
times of the tonick, but more frequently of the clonick 
kind. In the intervals of the spasms, the patient ap- 
pears to be perfectly well. The intervals between each 
spasm becomes longer or shorter, according as the dis- 
ease tends to life or death." 

And the doctor tells us he knows of no remedy for 
this disease but liquid laudanum, given in doses of 
from a small tea spoonful to a small table spoonful, as 
the case maybe more or less violent. For want of lau- 
danum, a little raw whiskey should be given, and the 
region of the stomach bathed with the same, warmed. 
If disease follows, we are to treat it according to symp- 
toms, but in general I would advise such patients, to live 



OF DROWNING, OR SUBMERSION. 381 

on thin mild nourishing articles for a few days, avoiding 
full meals; and if headach, or pain, or a feverishness re- 
main, they should be bled, or congestions of a danger- 
ous nature may be formed. Or a few mild injections 
mav be useful. 



SECTION IX. 

Of Drowning, or Submersion. 

Persons have frequently been recovered after remain- 
ing a considerable time under water, and sometimes not 
till after long continued efforts, therefore, in all cases, we 
are to act promptly, tenderly, and perseveringly. I have 
chosen to give the means suggested by the late amiable 
and learned Dr. James Cocke, of Baltimore, for the re- 
covery of drowned persons. 

"1. Remove the body from the water as speedily as 
possible, to the most convenient place; let the clothes be 
taken off gently, and let the skin be dried by the applica- 
tion of soft towels or sponges. Place the body on a ma- 
trass or blanket, and cover it with a blauket. It is de- 
sirable it should be on the back. Having the apparatus 
prepared. 

"2. Expand the luugs at the earliest practicable mo- 
ment; this may be done by introducing a proper pipe 
into the glottis; if one is at hand; otherwise by putting 
the nozle of a common pair of bellows into the mouth 
or nostrils and working it, the air being prevented from 
returning by closing the mouth and nostrils, and from 
descending into the stomach, by pressure on the thyroid 
cartilage (or Adam's apple.) If neither the pipe and bel- 
lows, nor the bellows alone, can be procured on the in- 
stant, it will be advisable to have the lungs of the patient 
expanded by the breath of an assistant. If the inflation 
of the lungs cannot be effected by these means, tracheo- 
tomy must be resorted to. In either case, after the air 
has continued about a minute in the luugs, it is to be 
pressed out again, and the lungs are to be re-inflated, 
which alternated action is to be supported until signs of 
animation return. 



"3. The temperature of the place, in which an attempt 
is to be made to restore the apparently dead from sub- 
mersion, should never exceed summer heat. When the 
temperature of the air and water is about sixty degrees of 
Fahrenheit, no additional warmth need he applied; when 
the temperature of the air is below sixty, a very gradual 
augmentation of it may be allowed, until it has attained 
that, point, beyond which it should not be increased by 
external means. The air used in artificial respiration, 
will, perhaps, furnish as much additional heat as ought 
to be applied, before there are obvious symptoms of re- 
turning animation. 

"4. Permit no unnecessary persons about the body, or 
to remain in the apartment, which should be freely and 
fully ventilated. 

"5. Let neither blood-letting, emeticks, agitation, nor 
the fumes of tobacco be resorted to. 

"6. Electricity, if used at all, should be very cautious 
ly exhibited, and never until the lungs have been fre<- 
quently filled with air and emptied alternately for the 
space of three or four hours, except m cases in which 
the subjects have been long under water, then electricity 
may be used earlier in the process, as a desperate re- 
medy. 

"7- Stimulant applications to the senses must be in- 
effectual, until animation is in some measure restored, 
without which there can be no sensibility. 

"8. The application of cordials to the stomach, and sti- 
mulating injections to the intestines, can only be useful 
after a passage for the blood, through the lungs, has been 
opened; they should not, therefore, be introduced before 
the lungs have been several times completely filled with 
air and emptied alternately, after which they may be 
serviceable; but nothing of greater bulk than four or five 
ounces of brandy or wine, or dilated aqua ammonice, or 
compound spirit of lavender, diluted, should ever be 
thrown into the stomach or intestines. 

"9- Every degree of friction is to be carefully avoided, 
until the lungs have been several times expanded, and 
the heart has relieved itself of its distention; after which, 
friction should be unremittingly and sedulously made 



OF DROWN INC, OR SUBMERSION. 383 

four or live hours, or until the circulation is re- establish- 
ed. Frictions should only be made with the hand, lubri- 
cated by oil. or with a piece of soft flannel, and always 
from the ends of the extremities towards the body. 

'•10. Persevere." 

It may be remarked of the above instructions that they 
differ in some measure from those usually given, or em- 
ployed, for the recovery "of drowned persons; but from 
w r hat I have seen practised in those cases without system, 
or any well-marked design, often embracing things the 
most discordant, I am led to consider the foregoing di- 
rections of high importance: they are founded on scien- 
tifick views of the subject, and detail the means with a 
regularity which I have no doubt will often ensure suc- 
cess. I wish also to observe that the doctor gives. more 
full explanations of his views in the Medical Recorder, 
from which this article was extracted, but which are too 
lengthy for insertion here. But as the whole of this was 
intended for the physician, who, it is always presumed, 
may make any small variation which may occasionally 
be necessary, I shall offer a few remarks. 

1. Xo caution is of more importance than to be care- 
ful in handling the body; in carrying it, a small incli- 
nation of the head, or twist of the body, may prove 
fatal. 

2. Let no authority, however respectable, induce you 
to use tobacco smoke. 

3. If the patient revives in some measure, and is kept 
long in a languid horrible state of life, in which he seems 
to be struggling with death, and apparently can neither 
recover nor die, we should in some measure transgress 
the doctor's rule for rubbinsr. I have seen a most dis- 
tressing case 01 this kind, where the patient was quickly 
relieved by brisk rubbing with a rough towel, till the. 
skin was much inflamed: but it is to be remembered 
that this would only exhaust the little remaining life be- 
fore the circulation is in good measure restored. 

I have some little doubt about the propriety of rub- 
bing only from the end of the extremities toward the bo- 
dy: I suspect the use of friction is not quite so me- 
chanical as to merely act by pushing on the blood. Be- 
sides, this view of the subject supposes the heart to be 



384 OF STRANGULATION FROM HANGING, &C. 

more capable of action than the veins; the reverse of this 
is nearer the truth; so that, by forcing on the blood be- 
fore the heart is able to act, we may crowd the heart un- 
duly, and thus prevent its action altogether. I imagine 
friction acts by its stimulus acting on the excitability, 
and thus renewing excitement, and therefore it is, per- 
haps, not material in what direction, we apply the strokes. 
But it must ever be remembered, that a reduced excita- 
bility is most easily destroyed by powerful stimuli, and 
therefore we are by no means to rub harshly, until the 
lungs and heart have in some measure resumed their ac- 
tion. Does this not explain the reason why electricity 
operated so fatally on the heart of drowned animals, in 
the experiments of Mr. Kite, as related by Dr. Cocke? 
And are we not warranted on this ground, never to ap- 
ply electricity in force, or any other powerful stimulant, 
until the excitability shall have been in some measure 
restored? 

4. Never let our efforts cease for many hours: per- 
sons have recovered after appearing lifeless for five or 
six hours. 

5. Never over- stimulate by means of outward heat, 
before there is considerable life. It is a pleasing coin- 
cidence, that while I offer the best instructions in those 
cases, I bestow a small encomium upon departed worth; 
this friend of science and of the afflicted is no more; but 
let us imitate his good examples, and while we mourn 
his early exit from scenes of usefulness, which pointed 
to fame, let us christian-like believe he has secured the 
place of rest! and benignly smiles on those who walk in 
the paths of rectitude and of honour. 

SECTION X. SUBSECTION 1. 

Of Strangulation from Hanging, and other Causes. 

Persons are sometimes found, who in a fit of despair 
hang themselves, or this may be wickedly done by 
others. We also meet with children who are overlaid 
by their mothers or nurses, which may arise either 
from carelessness or some disease of the nurses, such 



OF STRANGULATION FROM HANGING, &C. 385 

as fits. It is obvious no woman who is liable to con- 
vulsions of any kind, should ever take an infant into 
bed with her. 

Death in all these cases is occasioned by the depriva- 
tion of air, or its oxygen (unless the spinal marrow has 
been injured by a dislocation of the neck) and, therefore, 
I shall point out the means suited to such cases, with- 
out distinguishing them by the causes from which they 
originate. 

A first, and principal means, in all these cases, is the 
introduction of air into the lungs, as speedily as possi- 
ble, by means of an apparatus for the purpose, or by 
introducing air by a common bellows, taking care to 
press on the prominence on the throat called Adam's ap- 
ple, reasonably, so as to prevent the air going into the 
stomach, and also to close the mouth, and the other 
nostril; the air should be left, nearly a minute, and then 
pressed out again, and thus alternately inflate and gently 
press out the air, so as in some measure, to imitate the 
process of breathing. The body is to be briskly but 
gently rubbed, without intermission, while we entertain 
any hope. 

If we have a well grounded belief that the patient has 
not been strangled for a length of time, the application 
of cold water, by throwing it over the naked body, is a 
remedy which I beg leave to recommend, in preference 
to heating the body. I am supported in my opinion 
respecting the use of cold water, by the fact of its use- 
fulness in suspended animation from lightning, and also 
in great depression from intoxication, as well as in cases 
of dangerous fainting from too violent exercise, which 
sometimes occurs, in those unaccustomed to labour. I 
suppose it operates by rousing the lungs into action, and 
therefore in all cases of sudden depression or suspension 
of life, I think it one of the principal remedies, and very 
often the only one necessary, where the excitability or 
sensibility is not too much exhausted. 

If we examine into the means by wjhich animal heat 

is produced, we are sensibly met with the fact, that in 

what ever way it is elicited throughout the system, the 

process of respiration alone, can maintain it: and hence, 

49 



386 OF STRANGULATION FROM HANGING, &C. 

it follows, that where life is suspended by a sudden de- 
privation of ttir^the principal indication is to restore 
breathing; that the sudden application of cold water ex- 
cites the muscles of respiration into powerful action, is 
manifest from the deep inspirations which we are forced 
to make, on going into the cold bath, &c. If this opi- 
nion be correct, it applies extensively to depressed life, 
from the use of spirits, opium, narcotick poisons, over- 
heating, or violent exercise; and from inhaling delete- 
rious gasses, from lightning, submersion, strangulation, 
and, perhaps, all other causes which require a sudden 
restoration of breathing; and we derive encouragement 
from the fact, that in all cases, where it has been tried, 
it has answered our wishes, in a greater degree than airy 
other means, usually resorted to. 

Mankind seem universally to have adopted opinion* 
in good measure opposite to the foregoing, and seem to 
found all their hopes on infusing heat, and thus restor- 
ing life; and apparently from the simple belief that life 
is ever accompanied with heat, and heat being reduced 
in those cases, they seem to think, that to apply heat, 
must necessarily tend to restore animation. But I hope 
to prove by a few positions, that this opinion, or this 
practice, on whatever views it may be predicated, is un- 
philosophical, unchymical, and ill founded. 

1. Because heat is not a necessary condition of animal 
life, many cold blooded animals, as fishes, possess great 
vigour; if it be objected that this is irrelevant, I answer, 
it is no more so than the supposition, that extraneous 
heat shall have a friendly influence on depressed life. 

2. In most cases of sudden depression, which alone ( 
are under consideration, we have no evidence of the ex- 
penditure of heat; on the contrary, all the blood, nervous 
matter, and heat, are within, and the defection is occa- 
sioned by chymical or other operations, by which the 
heat becomes latent or hidden, and there is no more af- 
finity between latent heat, and that which is sensible and 
free, than there is between any other bodies in nature. 
The exceptions to these remarks are cases where the 
body has laid long in cold water, or exposed to a low 
temperature; here free calorick or heat, in obeying its 



OF STRANGULATION FROM HANGING, &C. 387 

general laws, will pass from the warm to the colder 
body, and, by congealing the fluids, will add to the danger 
of the case. But we are by no means to infer from this, 
that a hasty application of external heat, which has no 
peculiar animal principle combined with it, is likely to 
be useful in recovering life; for, simply to dissolve those 
congelations is one thing, to put them into motion is 
another, aud one which can only be affected by the ac- 
tion of the lungs, brain, heart, and blood-vessels; the 
main spring by which these are put into, and main- 
tained in, action, is oxygen derived from the atmosphere 
in breathing. 

3. If it be argued that by dissolving or rarefying the 
fluids, by external heat, we prepare them to be acted on 
by the lungs, &c; I answer, that until the lungs and 
brain act, these cannot move: if the principal vital or- 
gans act, heat is inhaled and distributed throughout the 
system, and elicited with a force and quantum which is 
especially suited to every part. 

4. And further, I think it obvious beyond denial, that 
the heart and brain are oppressed with a weight of blood, 
and to dissolve and crowd on the fluids, remaining in 
the vessels, before the lungs are expanded to empty 
the heart, and brain of their surcharge, is only to in- 
crease the disorder, by crowding them still more. Be* 
sides, the fluids in a temperature reasonably low, will 
not undergo decomposition so soon as in a higher tem- 
perature. 

5. The circumstances that a child will suffocate 
speedily in the warm bosom of its mother or nurse, and 
that a person hung in a warm room, or drowned in warm 
water, has no more chance of recovery than those placed 
in a reasonable temperature, must be admitted; nay 
more, I feel no hesitation in giving as my opinion, that 
those placed in a warm bed, &c. would die sooner than 
those in the usual summer temperature of the air, or wa- 
ter of rivers. 

Upon the whole, I am persuaded, the sudden application 
of a heat, greater than about sixty or seventy degrees, 
is highly dangerous, and further, I think it probable this 
.remedy has maintained its reputation principally because 



388 OF STRANGULATION FROM HANGING, &C. 

it can seldom be obtained, until the patient has in some 
measure recovered from frictions, from inflating the 
lungs, &c. 

Lastly, heat is a considerable stimulant, operating on 
the living body, under all circumstances, relatively, that 
is, the same degree of heat will produce an effect vastly 
different, in different conditions of the body; and when 
in any reasonably degree, will exert a greater force in 
proportion to the debility, or depression of the body, so 
that a degree of heat which might be friendly or inno- 
cent, to a body in health, may unduly stimulate in cases 
of suspended animation, and thus destroy the small re- 
mains of excitability. This observation applies to all 
stimulants, and, therefore, we are to commence in all 
cases with the mildest methods and means. 

I shall conclude my reasonings, on this subject, by a 
few remarks on the use of cordials, and on blood-letting. 
It is universally known that excess in the force of stimu- 
lants, applied to the body, will prostrate the strength, 
and may subvert every action. In what condition of 
the body, then, can we apply the greatest force of stimu- 
li? Will the enfeebled body, whether habitually or ac- 
cidentally so, bear the greatest force of stimuli? I an- 
swer it will not, and instead of more powerful stimuli 
being necessary, they will exert a greater influence in 
proportion to the reduction of the excitability, and when 
excitability is gone, life is extinct. If these ideas are 
correct, it follows that we may easily destroy the remain- 
ing excitability by throwing stimulants into the stomachy 
and therefore, they should never be given till the circu- 
lation is in some measure restored, and then, with a very 
sparing hand. In all sudden cases that are early dis- 
covered, a glass of cold water is a more rational and safe 
remedy; and where the body has laid a considerable 
time, a little warm tea, or the wine, or brandy, &c. 
usually given, should be largely diluted. 

Blood-letting can never be necessary until the lungs 
are restored in some measure, for, it is a fact well known, 
that in all cases under consideration, the left ventricle of 
the heart, the arteries, and the veins of the extremities, 
empty themselves and force the blood on into the great 



CONCLUDING ADVICE IN CASE9 OF SUFFOCATION. 389 

internal veins, the rigid auricle, and ventricle of the 
heart. How then are we to remove this disorder in the 
sanguiferous system, by abstracting blood from the 
veins? There cannot be the remotest hope unless it be 
by bleeding in the jugular veins; even this is doubtful, 
and may interfere with the more important means of infla- 
ting the lungs. So soon as the breathing has been re- 
stored, and of course the circulation in good measure, 
we should bleed moderately, and repeat according to 
circumstances, in order to lessen the quantity of blood, 
which must have suffered some deterioration, and thus 
enable the vessels, heart, and lungs, to perform their 
functions more easily, and thereby, prevent congestions, 
infarctions, or infraction, in some of the tender parts of 
the body. 

SUBSECTION 2. 

Concluding JLdvice in Cases of Suffocation. 

I here seriously beg leave to request the reader to read 
the first section of this article, and also the section, on 
submersion; and I go on to state what I consider the 
most likely means, for recovering those suddenly ex- 
posed to whatever may suspend life, for want of air. 
This more obviously includes submersion, strangula- 
tion, deleterious gasses, as those of mines, or wells, or 
old cellars, or chymical operations, and fainting from 
sudden overaction, blows, shocks from lightning, smo- 
thering, &c. 

1st Indication. Lay the body carefully on the back, 
with the head slightly raised. If the air is cold or wet, 
carry it with the utmost caution to a room well ventilat- 
ed, forbid unnecessary persons from coming in, for the 
lungs require the purest air. 

2d Indication. If the body is wet, or dressed, wipe the 
skin dry, or remove the clothes and commence gentle, 
but brisk, frictions all over the body, having a blanket 
under, and another thrown loose over the body. 

3d Indication. Apply a suitable apparatus to one nos- 
tril, or mouth, close the other nostril and mouth, or both 



390 CONCLUDING ADVICE IN CASES OF SUFFOCATION. 

nostrils; press on the prominent part of the throat, or 
Adam's apple; this will prevent the air from returning, 
before it has entered the lungs, and also from passing in- 
to the stomach; leave the air in some seconds, then press 
it out, by applying a hand gently to the abdomen, and 
in doing this, apply the hand pretty low down, so as to 
avoid pressure immediately on the stomach. For want 
of a proper apparatus, a common bellows may be used, 
and for want of these, the breath of a strong person 
should be forced into the mouth; this process in immita- 
tion of breathiug, must be constantly used while there is 
any hope. These means are more especially suited to 
submersion, or where the body has laid exposed to bad 
weather, or where we suspect the patient has been some- 
time affected. 

4th Indication. Throw cold water over the naked 
body and head; wipe the body dry, and repeat this a few 
times; if no benefit follows, resume your frictions, and 
inflation of the lungs; this remedy (the cold water) is 
particularly suited to injuries arising from narcoticks, 
blows, lightning, hanging, or suffocation, and least use- 
ful in cases of drowning; but even here, provided the 
body was taken up immediately, it ought to be used; and 
I may observe here, that the chance of success, from this 
remedy, will be in proportion to the earliness of its ap- 
plication. 

5th Indication. As soon as there are signs of life, give 
a little cool water, provided the accident has momenta- 
rily preceded; if some time has elapsed, a little warm 
tea, broth, wine and water, or brandy and water, may 
be given; giving preference always to the weaker arti- 
cles, unless the patient is known to be of intemperate ha- 
bits; here we may venture to give warm wine, or equal 
parts of brandy and water. This advice is applicable 
to all cases. 

6th Indication. Open the bowels with injections con- 
taining common salt. 

7th Indication. If life return imperfectly, and the pa- 
tient is harassed with a coming and going of the breath, 
and circulation, and this continues more than a few mi- 
nutes, bleed the patient in the arm, or jugular vein ; and 



OF SUBSTANCES STOPPED IN THE THROAT. 391 

increase the force of your frictions: if your patient re- 
vive under this treatment, put him to bed, cover mode- 
rately, let his room be well aired, give him a few draughts 
of warm tea, either common tea or chamomile, &c; and 
if he now incline to sleep, let him enjoy it. 

There will in general be great susceptibility to chills; 
and agairist these the patient must guard by dressing 
warm, taking warm teas, or broth, or panada, avoiding 
much liquor, which will over stimulate, and dispose to 
disease. Lastly. It has been proposed, that if the lungs 
cannot be inflated, that the windpipe should be opened, 
and air forced in and out, as before recommended. Cases 
may occur where a spasm may close up the glottis or 
opening from the mouth, and render this operation ne- 
cessary, but it will very seldom be found necessary, and 
can only, with propriety, be performed by a person ac- 
quainted with the anatomy of the part, 

SECTION XI. 

Of Substances stopped in the Throat, 

I have to acknowledge here, that I have seen but few 
accidents of this kind, and as I think well of the direc- 
tions given by Buchan, I have copied this article from his 
work. 

" Accidents of this kind are very common, and ex- 
tremely dangerous, yet they are generally the effect of 
carelessness. Children should be taught to chew their 
food well, and to put nothing into their mouths which it 
would be dangerous for them to swallow. But children 
are not the only persons guilty of this imprudence; many 
adults put pins, nails, and other sharp pointed substances 
into their mouths on every occasion, and sometimes even 
sleep with the former there all night: a fit of coughing, 
or twenty other accidents, may force over the substance 
before the person is aware. 

"When any substance is detained in the gullet, there 
are two ways of removing it, viz. either by extracting it, 
or pushing it down. The safest and most certain way 
is to extract it; but this is not always the easiest; it may 



392 OF SUBSTANCES STOPPED IN THE THROAT. 

be more eligible sometimes to thrust it down, especially 
when the obstructing body is of such a nature, that there 
is no danger from its reception into the stomach. The 
substances which may be pushed down without danger, 
are all common nourishing ones, as bread, flesh, fruits, 
and the like. All indigestible bodies as cork, wood, 
bones, pieces of metal, and such like, ought, if possible, 
to be extracted, especially if those bodies be sharp point- 
ed, as pins, needles, fish bones, bits of glass, &c. 

"When such substances have not passed too deep, we 
should endeavour to extract them with our fingers, which 
method often succeeds. When they are lower, we must 
make use of nippers, or a small pair of forceps, such as 
surgeons use. But this attempt to extract rarely suc- 
ceeds, if the substance be of a flexible nature, and has 
descended far into the gullet. 

"If the fingers and nippers fail, or cannot be duly ap- 
plied, crotchets, a kind of hooks, must be employed. 
These may be made at once, by bending apiece of pret- 
ty strong iron-wire at one end. It must be introduced 
in the flat way; and, for the better conducting it, there 
should likewise be a curve or bending, at the end it is 
held by,- to serve as a kind of handle to it; which has 
this further use, that it may be secured by a string tied 
to it, a circumstance not to be omitted in any instrument 
used on such occasions, to avoid such ill accidents as 
have sometimes occurred from these instruments slipping 
out of the operator's hands. After the crotchet has pass- 
ed below the substance that obstructs the passage, it is 
drawn up again, and hooks up the body along with it. 
The crotchet is also very convenient, when a substance, 
somewhat flexible, as a pin or fish bone, sticks across 
the gullet, the hook in such cases, seizing them about 
their middle, crooks, and thus disengages them; or, if 
they are very brittle substances, serves to break them. 

"When the obstructing bodies are small, and only 
stop up a part of the passage, and which may either ea- 
sily elude the hook, or straighten it by their resistance, 
a kind of rings, made either of wire, wool, or silk, may 
be used. A piece of fine wire, of a proper length, may 
be bent into a circle about the middle, of about an inch 



OV SUBSTANCES STOPPED IN THE THROAT. 393 

diameter, and the long unbent sides brought parallel, and 
near each other: These are to be held in the hand, and 
the circular part or ring introduced into the gullet, in 
order to be conducted about the obstructing body, and 
so to extract it. More flexible rings may be made of 
wool, thread, silk, or small pack-thread, which may be 
waxed, for the greater strength and consistence. One 
of these is to be tied fast to a handle of iron wire, whale 
bone, or any kind of flexible wood, and by this means 
introduced, in order to surround the obstructing sub- 
stance, and to draw it out. Several of these rings passed 
through one another, may be used, the more certainly to 
lay hold of the obstructing body, which may be involved 
by one, if another should miss it. These rings have one 
advantage, which is, that when the substance to be ex- 
tracted, is once laid hold of, it may then, by turning the 
handle, be retained so strongly in the rings thus twisted, 
as to be moved 'every way, which must, in many cases, 
be a considerable advantage. 

"A material employed on these occasions is the 
sponge. Its property of swelling considerably on be- 
ing wet, is the principal foundation of its usefulness here. 
If any substance is stopped in the gullet, but without 
filling up the whole passage, a bit of sponge may be in- 
troduced into that part which is unstopt, and beyond the 
substance. The sponge soon dilates, and grows larger 
in this moist situation; and, indeed, the enlargement of 
it may be forwarded, by making the patient swallow a 
little water. Afterwards it is to be drawn back, by the 
handle to which it is fastened, and as it is now too large 
to return through the small cavity by which it was con- 
veyed in, it draws out the obstructing body along 
with it. 

"The compressibility of sponge is another foundation 
for its usefulness in such cases. A pretty large piece of 
sponge may be compressed or squeezed into a small size, 
by winding a string of tape closely about it, which may 
be easily unwound, and withdrawn, after the sponge has 
been introduced. A bit of sponge may likewise be 
compressed by a piece of whale-bone split at one end; 
50 



894; OF SUBSTANCES STOPPED IN THE THROAT. 

but this can hardly be introduced in such a manner as 
not to hurt the patient. 

"I have often known pins, and other sharp bodies, 
which had stuck in the throat, brought up, by causing 
the patient to swallow a bit of tough meat tied to a thread, 
and drawing it quickly up again. This is safer than 
swallowing sponge, and will often answer the purpose 
equally well. 

"When all these methods prove unsuccessful, there 
remains one more, which is, to make the patient vomit: 
but this can scarcely be of any service, unless such ob- 
structing bodies are simply engaged in, and not hooked 
or stuck into the sides of the gullet; as in this case, vo- 
miting might produce some further mischief. If the pa- 
tient can swallow, vomiting may be excited by taking 
half a dram, or two scruples, of ipecacuanha in powder, 
made into a draught. If he is not able to swallow, an 
attempt may be made to excite vomiting by tickling the 
throat with a feather; and if that should not succeed, a 
glyster of tobacco may be administered in a sufficient 
quantity of water. It is made by boiling an ounce of to- 
bacco in a sufficient quantity of water: this has often 
been found to succeed, when other attempts to excite 
vomiting have failed. 

"When the obstructing body is of such a nature that 
it may with safety be pushed downwards, this may be 
attempted by means of a wax-candle oiled, and a little 
heated, so as to make it flexible; or a piece of whale- 
bone, wire, or flexible wood, with a sponge fastened to 
one end. 

"Should it be impossible to extract even those bodies 
which it is dangerous to admit into the stomach, we must 
prefer the least of two evils, and rather run the hazard 
of pushing them down, than suffer the patient to perisk 
in a few minutes; and we ought to scruple this resolution 
the less, as a great many instances have happened, 
where the swallowing of such hurtful and indigestible 
substances has been followed by no disorder. 

"Whenever it is manifest, that all endeavours to ex- 
tract or push down the substance must prove ineffectual, 
they should be discontinued; because the inflammation, 



OF SUBSTANCES STOPPED IN THE THROAT. 395 

occasioned by persisting in them, might be as dangerous 
as the obstruction itself. Some have died in consequence 
of the inflammation, even after the body which caused 
the obstruction had been entirely removed. 

"While the means recommended above are used, the 
patient should often swallow, or, if he cannot, he should 
frequently receive by injection, through a crooked tube 
or pipe that may reach down to the gullet, some emol- 
lient liquor, as warm milk and water, barley water, or 
a decoctiou of mallows. Injections of this kind not only 
soften and sooth the irritated parts; but, when thrown in 
with force, are often more successful in loosening the ob- 
struction than all attempts with instruments. 

"When, after all our endeavours, we are obliged to 
leave the obstructing body in the part, the patient must 
be treated as if he had an inflammatory disease. He 
should be bled, kept upon a low diet, and have his whole 
neck surrounded with emollient poultices. The like 
treatment must also be used, if there be any reason to 
suspect an inflammation of the passages, though the ob- 
structing body be removed. 

"A proper degree of agitation has sometimes loosened 
the inhering body more effectually than instruments. 
Thus, a blow on the back has often forced up a sub- 
stance which stuck in the gullet; but this is still more 
proper and efficacious, when the substance gets into the 
windpipe. In this case, vomiting and sneezing are like- 
wise to be excited. Pins, which stuck in the gullet, 
have been frequently discharged by riding on horse- 
back, or in a carriage. 

"When any indigestible substance has been forced 
down into the stomach, the patient should use a very 
mild and smooth diet, consisting chiefly of fruits and fa- 
rinaceous substances, as pudding, pottage, and soup. 
He should avoid all heating and irritable things, as 
wine, punch, pepper, and such like; and his drink should 
be milk and water, barley water, or whey. When the 
gullet is so strongly and fully closed, that the patient 
can receive no food by the mouth, he must be nourished 
by glysters of soup, jelly, and the like. 



396 OF SWALLOWING CENTS, BUTTONS, &C. 

"When the patient is in danger of being immediately 
suffocated, and all hope of freeing the passage is va- 
nished, so that death seems at hand, if respiration be not 
restored, the operation of bronchotomy, or opening of 
the windpipe, must be directly performed. As the ope- 
ration is neither difficult to an expert surgeon, nor very 
painful to "the patient, and is often the only "method 
which can be taken to preserve life in these emergen- 
cies, we mention it, but it should only be attempted by 
persons skilled in surgery." 

It may be remarked of the foregoing instructions, that 
they are quite ample; but, in general, I would recom- 
mend to persons thus unfortunately situated, not to be 
too precipitate, lest they do great mischief, by awkward 
attempts to extract the offending substance, and unless 
there is danger of immediate suffocation, it will always 
be most advisable to call in a practitioner. 

In addition to the usual danger of accidents from pins, 
we are sometimes endangered by an improper practice 
some cooks have of sticking pins into turkeys, &c. which 
they are about to roast, and afterwards forget to remove 
them. I once dined at a very respectable house; Judge 
Hamilton, of Pennsylvania, was a guest, where as ma- 
ny as four or live pins were found in a turkey; and a gen- 
tleman of the bar got a pin in his throat before Ave were 
aware of the danger. This should be a caution to cooks, 
and also to those who dine with strangers; for so small 
an article as a pin may easily escape their notice, and 
getting into the throat may do serious injury, and even 
materially endanger life. 

SECTION XII. 

Of Swallowing Cents, Buttons, &fc. 

Children sometimes incautiously swallow cents, half 
cents, buttons, and other indigestible articles, which 
may injure either from their hardness, roughness, or 
sharp points or edges. I have seen several cases, where 
such "articles were swallowed without any dangerous 
consequences following; but they are always to be ap- 



OF SUBSTANCES GETTING INTO THE WINDPIPE. 397 

prehended: and cases are on record of deplorable sali- 
vations, and other unpleasant effects having; followed the 
swallowing of copper; and therefore children should be 
taught, as early as possible, to view these practi6es in 
their proper and dangerous light, and severely correct- 
ed, when necessary, to break so dangerous a practice. 

I recollect reading a distressing case of a lad, who died 
about his seventeenth year from having swallowed a 
halfpeuny when a child; it bad stuck in his throat, and 
remained there until his death, and during all this pe- 
riod, was a source of great suffering. Children wbo nave 
swallowed such articles, must be kept from all harsh or 
heating diet, milk and other bland articles should be gi- 
ven; and the bowels should be frequently opened with 
castor oil; or rather a mixture of this and sweet oil; mu- 
cilage should be given. If fever comes on, it must be 
reduced by bleeding, &c. If there be severe pain, with- 
out fever, a few drops of laudanum should be given now 
and then. 

SECTION XIII. 

Of Substances getting into the Windpipe. 

This most alarming and dangerous accident occurs, 
pretty often; but perhaps, a more singular and distressing 
circumstance can scarcely be found, than the fact, that a 
sister of mine lost two fine boys, in less than two years, 
by each of them getting into the windpipe a bean, by 
which they were suffocated. Nothing can be attempted 
by unskilful persons in those cases, but a skilful surgeon 
should not hesitate a moment, to open the windpipe, and 
endeavour to extract the substance. Perhaps it would 
be well in all such cases, to raise the patient for a moment 
upon the head, and then lay them down gently with the 
head low, and by this means the article may possibly be 
thrown into the mouth, or lodged high up in the wind- 
pipe, where it will be much less irritating than on the 
lungs. In full habits we should bleed largely, and then 
Tteep down irritation, by the free use of laudanum. 



398 OF FISHING HOOKS, &C. 

I have seen a case where a delicate child, not more than 
five or six years of age, got a cherry stone into this situa- 
tion; he was affected frequently with violent coughing, 
and symptoms of suffocation from which he narrowly 
escaped; at the end of the third week, in a violent fit of 
coughing, the stone was thrown out, and he soon reco- 
vered. I am encouraged in recommending turning the 
patient up on his head, from the circumstance that on 
either side of the windpipe, pretty high up, there is a lit- 
tle cup or shelf- like cavity, where bodies as large as can 
well pass the glottis, may, and no doubt often do lodge, 
therefore, in turning the patient upon his head, the body 
should always incline to one side; but these attempts 
must not be repeated too often. I think it would be ad- 
visable always to bleed the patient pretty largely, and 
give a dose of laudanum; and obtain the best assistance 
as soon as possible. 

SECTION XIV. 

Of Fishing Hooks, and other pointed articles, sticking 
in the Body. 

I have known some shameful cases, in which persons 
who had got fishing hooks into the cheek, and other parts 
of the body, were considerably cut by medical men, in 
order to extract. When I resided on the Ohio, a lad got 
a fish-hook into his cheek, and within the mouth, the 
shank of the hook had a considerable flaw, which stood 
as a barb, and was fast to the boys round- a-bout; thus 
situated he exhibited a ludicrous appearance: but, the 
wonder of the case is this, an old surgeon who had serv- 
ed in the revolution was called, in my absence, but was 
not willing to act; I met him at the door, and was stop- 
ped by him, till he gravely told me to hold the shank firm- 
ly with the left hand, while with the other, with a bistoury 
I should trace out the hook, which would serve as a di- 
rector!! Finding the boy in this situation, I cut off the 
end next his jacket with cutting pinchers, and then with 
a plain pair, forced on the point which soon reached the 



©F EXTRANEOUS BODIES, &C. 399 

inside of the cheek, and was thus forced out, without 
any cutting of the parts. 

Let this be remembered, in all cases; you have nothing 
to do but cut off the line, if the hook is attached to one, 
and then force the hook on till the point turns out, which 
must necessarily take place from its curved shape. 

I beg leave to relate a case of ingenuity, related to me 
by a person of veracity. A child had unwittingly swal- 
lowed a fish-hook, attached to the line; a neighbour 
finding the child likely to be strangled, took a leaden 
bullet, put a hole through it, through this hole he slip- 
ped the line, and then suffering the bullet to fall into the 
throat succeeded thus, in speedily dislodging the hook, 
and drawing it up with the bullet, which served the dou- 
ble purpose, by its weight, of loosening the hook, and 
guarding the point while it was drawn upwards. 

Pieces of glass, bone, wood, metal, or old nails, &c. 
sometimes get into the feet and other parts of the body; 
these ought always to be extracted by means of tweezers, 
or nippers; but where considerable bodies are tightly 
wedged in, or broken off, as sometimes happen, with 
splinters of wood, it is necessary to cut down or enlarge 
the opening, which can only be done with safety, by 
those acquainted with anatomy, otherwise injury may be 
done by cutting arteries or nerves. The pain which 
follows these accidents should be mitigated, by reason- 
able doses of opium, and the solid will be preferable, 
Emollient poultices should be applied of mush, or bread 
and milk, in all considerable injuries of this kind; hut 
in slight cases the application of a bacon skin, or bit of 
old bacon will answer a good purpose. If fever follows, 
we must bleed, give cooling purges, enjoin a low diet, 
and mild cooling drink; if symptoms of tetanus, or lock= 
ed jaw occur, see the article on that disease. 

SECTION xv. 

Of Extraneous Bodies in the Nose and Mars. 

Children are often found, who unwittingly put beans 
and such like, into the nose, and in their attempts to 



400 OF EXTRANEOUS BODIES, &C. 

withdraw them, thrust them so far up, that it becomes a 
difficult matter to extract them. No article is more 
troublesome in these cases than beans, which swell so 
readily on being subjected to warmth and moisture, and 
by becoming thus enlarged, are very difficult to with- 
draw unless they are speedily discovered and extracted. 

I have always succeeded, in daylight, with the utmost 
ease, by simply grasping the nose firmly, high up, while 
with the flattened end of a common probe, I have care- 
fully got beyond the substance, and with a hooking-like 
motion forced it out: the handle of a small silver tea 
spoon, is well suited for this purpose. 

If a few efforts do not succeed, it will be advisable to 
send for medical assistance, otherwise much injury may 
proceed from the irritation, as suppuration, or injuries 
to the organs of smell. 

When substances have entered the ears, as cherry 
stones, beans, &c. (which children will sometimes intro- 
duce,) or insects, we are to attempt their extraction, and 
in this, I have always succeeded best with the flattened 
probe, a little bent near the point; the forceps which are 
often recommended for this purpose, are apt to let the 
body slip, and sometimes with a projectile force which 
sends it much further in, besides they occupy too much 
room, as their ends must always be further asunder, than 
the diameter of -the body. Live insects are best remov- 
ed by means of injections of oil, or camphorated spirits; 
see the article on earach. 



OF INFLAMMATION, OR PHLOGOSIS 



SECTION I. 



I HAVE so fully treated on visceral inflammation, and 
have had occasion to speak so repeatedly of inflammato- 
ry diseases, that I shall confine my remarks in this sec- 
tion, to that kind of inflammation only, which is found 
in the muscular or glandular parts of the body, but 
more especially among the muscles of the limbs. The 
only case of internal inflammation which properly be- 
longs to this article is the psoas abscess. 

This kind of inflammation follows wounds, bruises, 
fevers, &c. and in all cases of considerable severity, is 
accompanied with fever. 

Imposthnmations, healings, biles, stonebruises, &c. 
are consequences of this species of inflammation. And 
in all cases it can terminate but in three ways: 

1. By resolution or scattering. 

2. By suppuration or bealing. 

3. By mortification. 

In all cases of simple inflammation, provided there is 
no contraindications, we should endeavour at its com- 
mencement to disperse the disorder, by means of bleed- 
ing from the arm, topical bleeding by leeches, or scari- 
fying and cupping; by cooling embrocations, as sal. 
ammoniack in vinegar, or lead water, &c. with low diet, 
cooling drinks, rest, and purging. 

But where these cases succeed severe fevers, or vio- 
lence done the part, and which will not probably yield 
to discussive applications, we are to encourage suppura- 
tion by mild warm fomentations, and emollient poultices, 
51 



402 OF INFLAMMATION, OR PHLOGOSIS. 

frequently renewed; as every two or three hours; the 
best of these is, bread and milk, or mush containing 
linseed, ground elm bark, white lily roots, and such 
mild articles; and where the suppuration is tardy, in 
weakly or reduced habits, fomentations of bitter herbs, 
with the addition of onions to the poultices, and in cases 
still more tardy, a gum plaster will answer best, with oc- 
casional embrocations, with some stimulating oil. 

In all cases of tardy inflammation of every kind, and 
in all kinds of habits, I have remarked that a long con- 
tinuance of wet articles are injurious; and I feel full con- 
fidence in observing from considerable experience, that 
we ought never to continue washes, or poultices beyond 
the second week. -~ 

Suppuration is known to progress, by occasional 
chills; throbbing or beating iu the part; heat; redness, 
well defined, or marked in its circumference; and if not 
very deeply seated, by a prominence of the part, and a 
soft feel, indicating the existence of pus or matter: as 
the suppuration advances, the pain which was constant 
and severe, together with the throbbing intermits, and 
finally, iu good habits when the abscess is completed, 
pain almost ceases, for a time. But the matter must 
now be discharged by a sufficient opening which can on- 
ly be attempted by a surgeon, and which is always bet- 
ter than leaving the part to burst. After it is open, a 
poultice, in all considerable cases, is to be applied for a 
day or two; after which, a plaster of basilicon may be 
applied. 

If an abscess is deep seated, and we neglect to open 
it at the proper time, the absorbents gradually recover 
strength, if the habit is good, and taking up the matter 
will raise a considerable fever, or other unpleasant 
symptoms. 

I once met with a case of this kind in a boy, who had 
a large abscess formed in his arm pit; finding him la- 
bouring uuder considerable fever, and the tumour un- 
pleasantly hard about its circumference, I bled him, 
and a large quantity of distinct pus was floating in the 
blood. 



OF MORTIFICATION. 403 

I also met another case of abscess in the thigh, where 
the abscess, for want of opening, had nearly destroyed a 
boy of good constitution; but before I saw him it had 
terminated in a growing fleshy tumour, which was of 
considerable size. These cases should be a caution to 
all timid, or careless people, to take good advice, and 
never object to opening, when thought advisable by men 
of experience, otherwise severe, and irremediable con- 
sequences may follow. 

With a due regard to the local applications above re- 
commended, we must carefully bear in mind that there 
is a certain point, or force in inflammation, necessary for 
suppuration; and excess of force or action, either local 
or general, will as certainly terminate in gangrene or 
mortification, as where the force or action is below the 
suppurating point. And hence it follows, that we must 
attend to the general system, and if there be too much 
action, as manifested by fever, severe chills, excessive 
pain, or an absence of it, with considerable extension of 
the swelling, we should bleed, purge, and use general 
means for reducing action; and this course is often abso- 
lutely necessary after gangrene, or incipient mortifica- 
tion has supervened. 

If the patient is of weakly habit, intemperate, con- 
valescent from fever, &c. we must evacuate with great 
caution, if at all; more generally we must support the 
patient with light but nourishing food; a little good wine, 
bark, elixir vitriol, &c. 

But in both these opposite states of the body, we will 
sometimes be disappointed in our wishes, and gangrene 
occurs, or we may often meet with cases which have 
been mismanaged, and have, actually, terminated in mor- 
tification. 

/ 

SECTION II. SUBSECTION 1. 

Of Mortification. 

In entering on mortification, I must remind the reader, 
that I have elsewhere observed, that all our diseases are 



404* OF MORTIFICATION. 

but twofold, that is, morbid, or peccant action, is ac- 
companied either with an excess, or defection of excite- 
ment, and is to be arrested or removed by infusing an ad- 
ditional impetus into the blood and nerves; or, what is 
much more common, by abstracting stimuli, and thus 
lessening the impetuosity of those things. If inflamma- 
tion has resisted the usual remedies employed for scatter- 
ing or repelling it, or those used with a view of effecting 
suppuration, or if cases are found thus advanced, to this 
fatal and last stage of mortification, we must in some mea- 
sure vary the treatment. 

This species of inflammation is to be known by the 
absence of the usual throbbing, an increased heat and 
burning in the part, by a dirty ill-looking surface, blis- 
ters extending some distance around on the skin, which 
was sound before, and often by livid edges, or a dark 
coloured circumference, from which the skin peels off. 
When these symptoms occur, we ought to apply blisters 
entirely around the limb, but not immediately upon the 
sore, and at the same time, apply the carrot poultice, and 
repeat every two hours, washing the part clean once or 
twice a day with mild soapsuds, or milk and water, as the 
case is more or less inflammatory, if there is a raw sur- 
face: a perseverance in the use of this poultice, and wash- 
ing, with a repetition of the blisters if necessary, are our 
only hope, as external remedies. 

But Ave are carefully to attend to the general system 
and if there is well grounded belief, that the patient is 
labouring under inflammatory fever, we should purge 
gently, or bleed, give small doses of ipecacuanha and 
camphor, to excite slight nausea, and a mild perspira- 
tion; cooling drinks, with cremor tartar, or a little ni- 
tre, may be given, but all sudden evacuations are to be 
avoided; for, by a sudden prostration, we may invite the 
gangrenous action throughout the blood vessels; a low 
diet, and rest, and quietness, are by no means to be ne- 
glected. 

In the opposite state of the system, we are to use the 
same outward applications; or, perhaps, the addition of 
washing the sore twice a day, with a strong decoction of 
bark, applied in a tepid state. But internally we are to 



OF MORTIFICATION IN THE MOUTH, &C. 405 

use bark, snakeroot tea, wine, opium, a light but gene- 
rous diet, and elixir vitriol; remembering that the bark 
can never be useful in these cases, unless it is used large- 
ly, as two or four ounces or more, per day. 

If our remedies succeed, a distinct line of separation 
will be discovered about the edges, in part, this gradually 
spreads round, and healthy pus is deposited between the 
sound and unsound p&rt; or rather, the vessels of the part 
are lowered, or raised in their action, as the case may be, 
to the suppurating point, and pouring out healthy pus 
cast off the dead, or mortified part. 

A part gangrened, or in the first stage of mortification, 
may recover, but mortification is always actual death of 
the part, and must be thrown off; after which we are to 
treat the case as a common ulcer, remembering that the 
excitability of the part, is mostly of such a nature as to 
require pretty stimulant dressings, as the soapsuds; and 
basilicon, mixed with some spirit of turpentine. 

subsection 2. 
Of Mortification in the Mouth. 

Here some difficulty occurs from the impracticability 
of applying our usual remedies, we should reduce the pa- 
tient reasonably, if necessary, and then give the bark 
largely, the more the better, in general. The mouth 
should be frequently rinsed with water containing a little 
salt of tartar, and gargled constantly with a thin paste of 
raw carrots, or the expressed juice, mixed with a portion 
of good yeast; and if the disease passes through the 
cheek a blister should be applied. 

SUBSECTION 3. 

Of Mortification in the Toes. 

This occurs in aged persons, or those of very bad ha- 
bits, especially in cold weather, and is to be treated by 
simply giving pretty large, and repeated anodynes every 



406 OF PSOAS ABSCESS. 

few hours, and washing with tepid soapsuds, and mild 
poultices, applied tepid and repeated every few hours. 

SECTION III. 

Of Psoas Abscess. 

This is so called from its being formed in the psoas 
muscle, very large and powerful muscles which arise 
from the inside of the back, on either side, and passing 
along the loins they go out over the bones of the pelvis, 
and are inserted into the thigh bone. This disorder is 
probably induced by a bruise, strain, &c. of the back; or 
it may proceed from other causes, which produce absces- 
ses in other parts of the body. It commences with ten- 
sion, and pain of the loins, the pain soon extends up 
about the back and down to the thigh, and mostly, there 
is some difficulty of standing erect. These symptoms 
are often taken for affections of the kidneys, and hence the 
necessity of getting good advice early, in those cases, 
or bleeding, and reducing the body by all the usual 
means, particularly purging, and low diet, and rest. At 
the same time, deep scarifications and cups on the back 
of the loins, are to be used, provided the patient has not 
access to a skilful practitioner. For, if to the above 
symptoms be added, considerable chills and heats, and a 
dull throbbing pain, we are to apprehend suppuration 
will take place, and matter forming it will fall down about 
the seat, or into the thigh, and must be let out, or serious 
consequences will ensue. Therefore, wherever any con- 
siderable affectiou of this kind occurs, disclose your 
situation at once. Dr. Rush mentions a case of a young 
lady of great respectability and worth, who perished in 
consequence of concealing this disease, through a sense 
of shame, till all hope of recovery was past. 



OF COMMON PHLEGMON, OR BILE, &C. 1 407 



SECTION IV. 

Of Common Phlegmon, or Bile. 

These occur sometimes in habits apparently good, 
but where they are numerous, or frequently returning, 
we are always to suspect some defection in the habit, 
and should recommend the use of occasional purges, the 
use of cremor tartar and sulphur, with mucilaginous 
drinks; and a diet suited to the case; generally a vegeta- 
ble diet, but in weakly or depraved habits, a nourishing 
but light diet: avoid harsh, fat, or high seasoned food: 
mostly a milk diet will be proper, and if the stomach is 
weak, a little seasoning of ginger, horseradish, or other 
pleasant aromaticks should be mixed with it. As a lo- 
cal application, nothing, in general, will answer better 
than the bread and milk poultice, and when they are tar- 
dy, some onion may be added, and if still more tardy, 
discontinue the poultice, and use a gum plaster, or honey 
and flower, or sugar and soap, &c. 

section v. 

Inflammation, and Beating of the Breast, or Mamma. 

By a timely application of discutients, as cold lead 
water, or sal. ammoniack in vinegar and water, we will 
often succeed in healthy women, if early applied to, in 
repelling inflammation. Eut in general, there is such a 
dullness attends these cases, that these remedies can nei 
ther be applied with propriety, or prospect of success, 
here, bathing the part with the steam of hot vinegar; rub- 
bing for a length of time with warm oil; or applying 
warm dry salt, together, with bleeding, purging, cooling 
diet and drinks, rest, &c. unless a considerable debility 
or depravity of habit forbid these evacuations, in which 
case we must use mild diaphoreticks. as nitre and cam- 
phor, opium and ipecacuanha, &c. 

If suppuration advances, nothing will answer better 
than the bread and milk poultice, and to poor person* 



408 OF INFLAMMATION OF THE NIPPLES. 

who cannot well procure this, well mashed potatoes, or 
mush with flaxseed, lily roots, or elm bark will answer 
equally well; and as soon as matter is formed it must be 
let out by a puncture, with a lancet; the poultice may be 
changed in a day or two afterwards, for the common 
basilicon, taking care, to keep the breast warm by a 
covering of tow, or wool, or a few folds of flannel. 

Should ulcers form and not heal kindly; take about 
four ounces of water, or near a gill, and add to it one 
tea spoonful of honey, and to this, half a dram of calomel, 
shake well every time before using, which is to be done 
by injecting into each opening or ulcer, a small syringe- 
ful of it once a day. This I recommend from conside- 
rable experience of its universal innocence, and great 
success in my practice. 

SECTION VI. 

Of Inflammation of the Nipples. 

This is sometimes a very troublesome and painful af- 
fection; in slight cases, it will often be sufficient to wash 
the part clean with milk and water, before the child 
sucks, and afterwards, or when it has sucked, with a 
weak solution of borax in rose water, or in common 
spring water. 

If this does not succeed, nipple glasses, or medicated 
wax caps should be worn; these are made by mixing 
some ground armenian bole, with the melted wax, and 
pouring this into a tea cup until it rises about three 
fourths of an inch from the bottom, into this a smooth 
piece of wood the size of the nipple, is to be put while 
it is cooling, and forced near to the bottom; when the 
wax is taken out, a small hole may be made through], 
which will suffer the milk, which weeps out to pass 
away. 

With the use of the nipple glasses, or caps, the wash 
of borax, is to be continued; if this does not succeed in 
a few days, wash with French brandy, or mix equal 
parts of very clear lime water and oil of almonds; apply 
this as soon as the child has sucked, or every few hours: 



OF INFLAMMATION OF THE FINGER, OR FELON. 409 

and before it sucks, the nipple should be washed, which 
will promote the healing of the parts; but neither of these 
articles, recommended, will injure the child. 

With due cleanliness, and in gross or full habits, an 
occasional dose of physick, and a reasonable diet, avoid- 
ing much heating articles of food, or drink, and keeping 
the bosom reasonably, but by no means too warm, will 
generally answer every purpose. 

And, I beg leave to admonish patients of this kind, 
Hot to be too ready to adopt the advice of officious, or 
anxious persons, who, often with much willingness, but 
little judgment in inflammation of the breast, undertake 
to prescribe. I have seen many bad consequences from 
random applications, either wrong in their nature, or 
too frequently changed. 

SECTION VII. 

Of Deep seated Inflammation of the Finger, or Felon, 

This is a most painful and tedious kind of disorder; 
mostly, it is seated in the periosteum, or, perhaps, in the 
bone itself: this constitutes the worst kind of felon, and 
it is especially apt to attack the joints. But there are 
slighter cases which are seated in the muscle, or cellular 
substance of the part. All these cases are extremely 
painful, owing, in great part, to the high degree of sen- 
sibility which the fingers possess; but, perhaps, it is oft- 
en augmented by the thickness and strength of the skin. 
When the pain seems deep seated, or about the joint, 
we may, in general, prognosticate unfavourably. 

The finger affected should be held in spirit of turpen- 
tine, as hot as it can be borne, or spirit of wine, or for 
Want of these, hot water. In heating these inflammable 
articles, care must be taken not to set them on fire. If 
the spirit of wine, whiskey, or turpentine, is put into a 
vial, and this stopped, loosely, with a rag, and then put 
into cold water; the whole being now put over the fire, 
may be heated without danger; want of care in this mat- 
ter, might, by a sudden flash, materially injure the face 
or eves. If these articles do not succeed, the best thing 
52 



410 OF STONEBRUISES, AND OF BLOODBILES. 

we can do is to cut down, at one stroke, to the bone, with 
a sharp knife; but a surgeon will always do this most 
easily. 

If these remedies are ineffectual, or neglected, suppu- 
ration will progress, and will in the main, be more or 
less tedious, as the disease lies deep or shallow. When 
we find suppuration unavoidable, it must, in all cases, be 
promoted by the mildest fomentations and poultices, 
and nothing will answer this purpose better than bath- 
ing the part, for half an hour, in warm milk and water, 
at every renewal of the poultice, which ought to be eve- 
ry two or three hours. And the patient may always, 
with great advantage, take full anodynes, morning and 
evening; if they interrupt sleep, the patient should be 
bled, and take a purge. This mild treatment will an- 
swer our wishes more completely than any more heating 
articles, which are often applied, and often to the great 
injury of the patient, by increasing the pain, and some- 
times occasions the loss of a finger or joint. 

SECTION vin. 
Of Stonebruises, and of Bloodbiles. 

Stonebruises are a little bloody bile seated in the 
sole of the foot, and are, perhaps, seldom found, except 
in those who go barefooted. It is extremely painful, and 
owing to the thickness of the skin, is very tedious. The 
best treatment is to soak the foot well in warm water, 
and then pare down as close as possible, and then a 
poultice of bread and milk may be applied as usual. 
When the presence of matter is ascertained, by some 
abatement of the pain and prominence, and softness of 
the part, an incision should be made, but this need ne- 
ver be large; a poultice should be continued a day or 
two, and then a plaster of basilicon will answer. Great 
care is necessary to keep the dirt from getting into the 
sore. 

Bloodbiles, as they are called, are, perhaps, nothing 
but common biles, which, by corroding some of the small 
blood- vessels, fill the cavity with a mixture of blood 



BITE OF THE VIPER. 411 

and matter, or a stroke which ruptures a small vessel, 
may be followed by a beating, and the quantity of blood 
extravasated cannot be changed into pus, but acquires 
a dark appearance. These, however, cannot always be 
distinguished, nor need the treatment be different from 
that of common biles. But in general, after they are 
opened, they require more stimulant dressings, as the 
basilicon, containing a little ground red precipitate, or 
a little ground savin leaves. 

SECTION IX, 

Inflammation from the Bite of Poisonous JLnimals. 
subsection 1. 

Bite of the Viper. 

I shall, here, first speak of the bite of our serpents; 
and also, of those insects which can annoy us by their 
stings, particularly when they unite, and thus inflict a 
considerable injury. 

The viper is found in this country; but they are neither 
numerous nor particularly vicious. I believe it is now 
pretty well ascertained, in England, that oil used with 
freedom, is a principal, and often the only remedy ne- 
cessary. Sucking the part bitten immediately, with the 
mouth, is also strongly recommended; and it is said to 
be free from all risk to the operator, especially if he 
use the precaution of rinsing his mouth frequently with 
oil. A mild emetick is also recommended; and washing 
the part with alkaline washes, together with the free use 
of vinegar. 

subsection &. 

Bite of the Rattlesnake and Copperhead. 

Although these are different snakes, they are about 
equally poisonous, making allowance for size and 
strength of the rattlesnake; and the same remedies will 



412 BITE OF THE RATTLESNAKE AND COPPERHEAD. 

answer, equally well, in all cases. But after much re- 
flection, I am much at a loss to lay down the best treat- 
ment. I have seen several cases of bites by the cop- 
perhead, but none by the rattlesnake till sometime after 
the accident. At one time the juice of plaintain and 
hore hound was much celebrated; and was first pre- 
scribed by a negro of Carolina. He gave a spoonful of 
the expressed juice of these herbs, mixed, and repeated 
it a few times; a leaf of tobacco was applied to the 
wound. Alkalies outwardly applied, and taken in so- 
lution by the mouth, has been recommended. Scarify- 
ing the part has been practised. Drawing with small 
cupping glasses is advisable, after having made an inci- 
sion into every mark of the tooth, through the skin, but 
it ought not to be made deeper. If we omit to cut 
through the skin, by its swelling, it may so completely 
close the punctures, made by the teeth, as to prevent the 
suction from reaching the poison. If such glasses are 
not to be had, a hen may be set with the naked fundament 
upon the part; and, I have been credibly informed, this 
has succeeded well, and that several hens have been 
thus killed in one case, which seems to raise the belief 
that the poison was thus forcibly extracted. But from 
what I have heard from various cases of snake bites, I 
imagine the plentiful use of warm oil is the best reme- 
dy; and perhaps nice fresh butter or lard would answer 
equally well. 

I cannot undertake to reconcile the common report of 
the innocence or harmlessness of the poison of the rat- 
tlesnake, with the fact that the late Dr. Barton of Phila- 
delphia, nearly lost his life by tasting the poison, very 
largely diluted with water. But I think myself clearly 
justifiable in cautioning persons from such a practice; a 
wine-glass, or small cup or an air pump, when either 
can be procured, will answer; for any sore about the 
mouth, or any accidental biting of the tongue, &c. might 
prove fatal. 

The Indians are said to be successful in treating cases 
of this kind. I can neither deny, nor support this re- 
port. I have seen one case of a bite, in the hand, which 
was treated by their mode; the suppuration which fol- 



OF THE STINGS OF INSECTS. 413 

lowed was tedious and severe; extending to the perio- 
steum, and bone; but the patient stated that the acute 
pain, and fever, had been less severe than common. 
What they used I know not, but the hand and arm was 
made to sweat considerably. 

Warm oil has been recommended for exciting sweat- 
ing in cases of fever, and it is probable that brisk, fric- 
tions with warm oil, over the whole limb on which the 
bite was inflicted, would be a principal remedy. In all 
the cases which I have seen of persons who had been 
bitten by the rattlesnake, severe, tardy, and painful, 
suppurations continued some time, bearing a strong re- 
semblance to scrofulous suppurations. Active stimu- 
lants are best suited to these cases, as fomentations of 
the stramonium or Jamestown weed, and the basilfcon, 
rendered more active by adding a little ground red pre- 
cipitate, or the savin oil, or savin leaves ground fine. 

subsection 3. 

Of the Stings of Insects. 

These are inflicted on us in this country, by the com- 
mon honey bee, the humblebee, hornet, wasp, yellow 
jacket, musketoes, &c. In general, violent pain suc- 
ceeds the stings of all these, except the musketoe, but 
danger never succeeds unless a number unite in this lili- 
pution warfare, and under these circumstances, even the 
musketoes become what the fellow called galley -nippers, 
w r ho for a wager, had undertaken to brave these little war 
riours, and who lost his stake by his opponent applying a 
bite of tire, without his knowledge, on which he sprung 
up and cried out a galleij -nipper, by Jehu! If, then, these 
insects sometimes become galley -nippers in earnest, from 
their number, or happening to unsheath their powerful 
swords in a tender part, we are sometimes in need of re- 
lief. The application of salt and water, applied cold, will 
answer a good purpose; or strong cold vinegar may be 
applied: if these do not succeed, rub the part well with 
warm sweet oil. And in bad habits, if little ulcers sue 
ceed, wash the part with brandy; with a strong solution 



414 OF MINERAL AND VEGETABLE POISONS. 

of lead; or apply some stimulant oil, as British, Colum- 
bian, or seneka oil. 

section x. 

Of Mineral and Vegetable Poisons. 

The success of remedies in cases of poison,, will, ge- 
nerally, be in proportion to the earliness of their applica- 
tion, and, therefore, every person ought to know what is 
to be done on these occasions, which often arise acciden- 
tally in children, and others, by taking arsenick which 
has been set for rats, flies, &c. also from cobalt, which 
is set fdr fly poison, and contains arsenick, as its active 
part. 

The attention of medical men has been much directed 
towards finding particular specificks for poisons, but, lit- 
tle success has attended their efforts, and all that is known, 
on the subject is of no value. It may be remarked, 
however, that vinegar which has been generally recom- 
mended for vegetable poisons, would be dangerous in 
the mineral: and I have strong doubts about its efficacy 
in cases of vegetable poison. All mineral poisons be- 
come active only so far as they are opened in their tex- 
ture, or oxydated by acids, or oxygen, and, therefore, 
acids are to be carefully avoided. 

In all cases where it is known poison was swallowed, 
we should, if possible, instantly, give a dose of white vi- 
triol, as from ten grains to twenty, every five or ten mi- 
nutes; and to adults from thirty to fifty grains. Then, 
with all possible speed, give large quantities of sweet 
milk and oil, or melted fat, or, for want of milk, warm 
water; as soon as possible, let a muscilage of slippery 
elm bark, or linseed be prepared, and given in large 
quantities; these, iu general, are better than oil; but al- 
ways require time for their preparation, which is well 
occupied by the free use of milk, or warm water with 
oils or fat. 

If no vomit is at hand, oil and milk, or warm water, 
are to be forced down, largely, and rapidly, and if the 
patient does not vomit immediately, put the finger or a 



OF MINERAL AND VEGETABLE POISONS. 415 

feather into the throat, and thus provoke vomiting. The 
patient, especially if he has swallowed arsenick, or other 
minerals, must continue the mucilaginous drinks till the 
stomach has recovered its healthy state. The bowels 
ought, in all cases, to be opened with mild, or purgative 
injections, as the case may require. 

If fainting occurs, of an alarming appearance, throw 
cold water over the patient; and I think this would be 
advisable in all severe cases of narcotick poisons, as opi- 
um, stramonium or Jamestown weed, nightshade, and 
ardent spirits. 

Many accidents arise from children's eating the seeds 
of the stramonium; thousands of families suffer their 
houses to be surrounded with this dangerous poison, 
without ever cautioning their children to avoid it. Many 
others are found who are in the habit of dosing their 
children with laudanum, or Godfrey's cordial, and leav- 
ing it in the reach of children, of which they unwarily 
take an overdose. I have met with cases of this kind, 
where the mother, or others, have been disingenious, or 
weak, or silly enough, to conceal these things from the 
physician, till after a recovery. 

Let it be a matter of importance, with all families, to 
keep the stramonium, the nightshade, opium or lauda- 
num, from the reach of children; or carefully impress on 
their minds, the danger attending the swallowing of these 
articles. And let arsenick, and fly poison, be touched 
with great caution: I have seen many deplorable cases of 
accidents, from mistakes with these articles, which had 
been set for the rats. 

In all cases of severe pain of the stomach of healthy 
children, or sudden extreme sickness or violent delirium, 
we are to suspect poison, and if there be any doubt of the 
fact, with all possible speed get a physician, or on strong- 
er conviction, administer the remedies mentioned in this 
section. In addition to the danger of fatal mistakes, which 
may occur from setting poison for rats, an awful opportu- 
nity is hereby given to evil minded persons, should any 
be about you. to do mischief and cover it under pretence 
of mistake . 



OF THE DISEASES OF WOMEN 



SECTION I. 

Introductory Remarks. 

IT is my design here to speak, first, briefly of the prin- 
cipal peculiarity of the female constitution; secondly, of 
their diseases; thirdly, of pregnancy; fourthly, of partu- 
rient women. 

The general delicacy of structure in the female system, 
must be familiar to every person; it may not be amiss, 
however, to point out a few of the most striking. Their 
limbs are better rounded, their skins are softer and 
smoother, their bodies are smaller, their whole body is 
less firm, than that of man; and, while a certain combi- 
nation of these forms female bodily perfection, true femi- 
nine excellence and beauty exists in the mind, and the 
face divine. 

What charms? what power? arise from the proper 
government of the female face. Here lies all true beauty 
and excellence, not, indeed, in the regularity of features, 
but the operations of the soul within. We are certainly, 
much inclined to admire the regular well formed features, 
which are, usually, denominated pretty or beautiful. But 
let not vanity attach to these pretty features; she is a 
proud jade, of a low character, and would ever humble 
the female, by dipping the face in poison, which shall 
wholly banish from it that holy and bright mirror, which 
shone in the face of Moses after conversing with his Ma- 
ker. Here the mind, in a manner partaking of its heav- 
enly beautitude, wrought up the features of a man to 
such a state of beauty and perfection, that the vulgar or 
wicked eye could not behold it, without pain: and least 
of all in the train of observers, of this heavenly face, 



OF THE DISEASES OF WOMEN. 417 

w a*, probably, what the world terms beauty. For, this 
beauty of face" was wholly different from common beauty, 
and would have shone with equal splendour over the 
face of age, and was especially calculated to humble the 
vanity of common beauty, because it was calculated to 
equalise, and to mock to scorn the boastings of the 
proudest models of clay, while the homely exterior rose 
to its destined elevation. This narration is so impres- 
sive and so strikingly calculated to show the real nature 
of beauty, that I shall quote the three last verses of this 
chapter of Exodus. 

"And till Moses had done speaking with them, he 
put a veil on his face. 

••'But when Moses went in before the Lord to speak 
with him, he took the veil off, until he came out. And 
he came out and spake unto the children of Israel that 
which he was commanded. 

"And the children of Israel saw the face of Moses, 
that the skiu of Moses' face shone: and Moses put the 
veil upon his face again, until he went in to speak with 
Him." 

Here, then, we have a strong case of divine perfection 
and beauty, which may be associated with the organs 
of life; and, although we are not to expect so high a 
display of it in this life, we are justifiable in the belief, 
that dignity of soul is ever a tvoe, or resemblance of this 
excellence; and that genuine beauty is that angelick 
serenity and steady lustre of face, which flows from in- 
ward workings of the mind. And, it may be worthy 
remark, here, that common beauty is characterized by 
so much of a " sameness, that it loses much of its appa- 
rent value, from that circumstance: while genuine beau- 
ty, flowing from virtue and other divine perfections, has 
a progressive quality of improvement, which renders it 
more and more beautiful; and as it progresses in the 
contemplation and discovery of the supreme fountain, 
shall become more and more sensible of the little com- 
parative value of bodily exterior, and of the unalterable 
greatness, goodness, and mercy, of that Being from 
whom every creature receives being, and whose face 
shall ever be veiled, for He has said. "Thou canst no! 
53 



418 OF THE DISEASES OF WOMEN. 

see my face: for there shall no man see me and live." 
Thus it would appear that to see the divine perfection 
would produce extinction, and that, as the creature shall 
become more intelligent, the great Supreme will recede 
more and more, by the splendour of his immeasurable 
wisdom, and perfections. 

I hope I shall be pardoned for carrying my illustration 
a little further; and I wish to call the attention of the 
reader, again, to the circumstances attending the case of 
Moses: "lie put the veil upon his face:" here we may 
suppose, not only, that such was the vast serenity and 
dignity of his countenance, that it would have humbled 
the beholders in so great a degree as to have destroyed, 
or have materially impaired their faculties of mind, but, 
also so strongly impressed on his mind an increase of 
the divine nature, that it would have exposed the weak- 
ness and corruption of his kindred to have seen them 
when he was thus clothed with this additional mental 
power, arising from so striking a display of Deity, and 
would probably have given him future pain; and hence, 
he was veiled till his mind had fallen to its regular hu- 
man state or condition. 

I hope it will be perceived that these observations on 
beauty, are intended to impress on the female mind, or 
rather the mind which is associated with the female 
economy, that while feminine beauty consists here, in 
good part, in cleanliness, reasonable dress, &c. that per- 
manent worldly beauty consists, principally, in a tem- 
per, and actions, corresponding with real excellence, 
which knows no sex. What value is there in the but- 
terfly's gaudy dress? these ephemeral tinsels, like the 
flower of the morn, are cut down at eve! But if these 
are the idols of the female heart, or if these come at the 
expense of virtue! I shudder at the thought. 

Let me, then, admonish the female, to abhor the 
thoughtless, the wicked practice of tight lacing, for the 
improvement of the shape; for common sense, religion, 
and your relation to this world, forbid this practice: nei- 
ther do you gain one advantage from it; for I do aver, 
without fear of contradiction, that many homely women 
have reciprocated with their husbands the utmost felicity, 



OF THE DISEASES OP WOMEN. 419 

compatible with this life, who, in the common accepta- 
tion of the word, were really homely; and I can point 
at once to the family of our immortal Washington. 
Where, or what, were the charms which captivated the 
hand, the heart, the very soul of this great man? Was 
it a woman squeezed thin as the reed, or was it the wo- 
man all seusibility of show, or of vanity? No, no; it 
was the eye which sparkled with virtue, and with that 
serene and lovely spark of Deity, which, nurtured and 
cherished within, displays the index in the expressive 
eye! In this heavenly organ, which says, to every lan- 
guage, cease to speak of me, for thou art dumb, Wash- 
ington read the movements of the soul. 

And let it not be forgotten, that this kindred eye was 
suited to the choice which his judgment approved; while 
the shallow tinsel covering the empty or vicious mind, 
or even the refined mind without energy of body to give 
action to the living sparkler, will ever be most likely to 
captivate the empty beau, whose discernment is as shal- 
low as his flatteries are temporary; for so soon as the ex- 
terior charms are gone, what he took for gold is found 
to be but tinsel! And the days of age are days of hea- 
viness! while, of all others, the days of age are the most 
happy to those whose souls, as it were, are fed by the 
same oil — the smooth and silvery flames of life unite, 
while Deity, smiling propitiously on the happy union, 
spreads over the evening of their days the kindling elec- 
tron, to lengthen out the flame of life, and gradually 
leads to that happy condition where naught is fashioned 
by hands, and where distinction of sex is unknown. 

I have said, your relation to the world required your 
avoiding this unwise custom; if it be asked, "whose 
concern is it, if I injure myself; I am the sufferer, and 
if I choose to run the risk who has a right to object?" 
I answer, that this language can only be just, on the sup- 
position that the consequences are confined to yourself; 
but have you ideas of becoming a mother, and of entail- 
ing misery on your offspring? if you view this lightly in 
anticipation, its realization will be doubly severe, and the 
idea that you, by the follies of your youth, rendered your 
child miserable, or have brought it into the world to suffer 



420 OF THE DISEASES OF WOMEN. 

and to die, will wring your heart with the most poignant 
grief, and shade the hair of your head with the silvery 
frost ere the season come; or may, in the morn or noon 
of your life, lead you to that gulf of poison, where con- 
sumption on downy wings wafts her seeds, and finding 
the kindred soil in your little, impoverished, confined bo- 
som, there she plants the deadly seed; and while your 
soul ardently desires the converse of kindred or friends, 
this cruel foe of the female, lops off at every stroke ano- 
ther thread! and soon closes your eyes from the vanity of 
tinsel, and the cutting and galling machines, which you 
have proudly, vainly worn, in defiance of friendly ad- 
monitions. 

Oh! mothers, how long will you tolerate this slow me- 
thod of suicide? rise up in your real nature; clothe your 
minds with the vestments of angels, and as you yield up 
the nectar, from your ivarm bosom, instil into your male 
child an abhorrence to murder, in the form of duelling, 
and of intemperance; and into the female, an abhorrence 
to the vicious practice of tight lacing; then shall ye dis- 
charge the most sacred duties of mothers, and while you 
enjoy much felicity here, from the reciprocated affection 
of your daughter, whose heart dilates, unconfined, to a 
proper size, and fills the woman, not with undue sensi- 
bility and irritability, but with the big, good, feminine 
heart, which can enjoy itself, and impart to the man of her 
choice felicity and happiness, never known where a for- 
bidding constitutional debility is predominant; you may 
then close your eyes on the world, in the belief that you 
have performed one of the greatest works towards the 
maintenance of health, to your posterity; and may be 
greeted, at the final call, with the cheering voice of the 
host of heaven. 

SECTION II. 



Of the Menses. 

I pass on to speak of that peculiar habit which so 
strikingly distinguishes the female, and on the regularity 
of which their health in some measure depends, from 



OP THE MENSES. 421 

years of discretion, till the evening of life, I mean the 
menses. As the means which have been pointed out, in 
various parts of this work, for the promotion or mainte- 
nance of health, is equally suited to the female; and as 
temperance, regularity and activity, will alone infuse 
health, I shall proceed to point out, the different periods 
at which this discharge requires particular attention; and 
then speak of it in the diseased state. 

In speaking of those interesting periods, I think pro- 
per to premise, that in general a great errour prevails in 
supposing health is maintained, only, by this secretion of 
the menses; and that when it is disordered, we have no- 
thing to do but procure its return, and health follows of 
course. This is an errour, for many women who men- 
struate tolerably regular, are unhealthy; and many du- 
ring acute and other diseases menstruate without any ma- 
nifest advantage, or injury from it. 

It must be admitted, that this discharge is of vast im- 
portance to the female; and where it is long absent, or 
irregular, the health is bad; but the truth is, that some 
disorder generally precedes these irregularities; and thus 
the disordered menses is not the cause of the disease, but 
the disease is the cause of this obstruction, or irregularity. 
So that we are to direct our attention to the state of the 
system, and prescribe according to symptoms; and the 
menses return as a matter of course. 

This errour respecting the female habit may be com- 
pared to the notions of the ignorant, about appetite when 
sick; all their lamentations are about eating, and they are 
ever pestering the physician for something to restore the 
power or desire of eating; not knowing, or stopping to 
reflect, that when the disease is removed, appetite returns 
as a matter of course. So with the females, when their 
menses are disordered, they stop not to inquire the cause, 
or to reflect that they are diseased, and that when this 
disease is removed, the secretion being a natural condi- 
tion of the healthy woman, comes again when health re- 
turns, with as much certainty, and under precisely simi- 
lar circumstances, as the appetite of the case above re- 
presented. 



4&& OF THE MENSES. 

This view of the case is of vast importance, and should 
fee a caution to females, not to take the rash advice of old 
women, who under the sanctified appearance of age give 
advice, often unsafe, because predicated on false views, 
or rather without any view at all, except it be that of 
wishing success; and it is a lamentable fact, that those 
who are the least competent, are the most willing to ad- 
vise; and incalculable mischief is done to females, by the 
mistaken notion of forcing the menses. 

All the usual remedies are of a heating nature, or what 
they call forcing, and it must be evident, that if a woman 
is labouring under inflammatory diseases, which are most 
common, these heating articles must do immense mis- 
chief: consumptions, and other fatal diseases, are the 
consequences. 

Let me then admonish the female, that, under all cir- 
cumstances, she is to pay especial regard to her general 
health, and in ninety-nine cases of an hundred it would 
be better if she paid no regard whatever to her menses, 
as a part of her disease. 

If you have an inflammatory disease, it will be most 
speedily and safely removed by the usual means, as 
bleeding, purging, Jow diet, &c. 

If you are affected with chronjck debility, or with low 
disease, tonicks and stimulants, as bark, iron, exercise, 
generous but light diet, &c. will restore the tone of body, 
and in either case, as health returns, the menses comes 
as a matter of course. 

I have long been so sensible of this true state of the 
case, and also that this trifling secretion once a month, 
when fully established, operates principally on the ute- 
rine system; and by giving health, and a proper degree 
of excitement there, contributes, indirectly, to the wel- 
fare of the general system, that for several years of an 
extensive practice, I paid no more attention in acute dis- 
eases to the menses, than I did to the appetite for food, 
for I was well convinced from observation, that of what- 
ever importance the regular recurrence of the menses 
may be to women, that it is only to be regulated or con- 
trolled, by due attention to the usual means for promot- 
ing health, when health is present, and in disease, by 



OF THE APPEARANCE, &C. OF THE MENSES. 4S3 

examining into the symptoms, and founding our indica- 
tions of cure, on them. 



SECTION III. 

Of the Appearance, and Disappearance of the Menses. 

The commencement of the menses, which occurs from 
the thirteenth to the seventeenth year usually, and which 
ceases from about the fortieth to the fiftieth year, are pe- 
riods which are supposed to be particularly interesting. 
That this change operates very powerfully on the system, 
at both these periods, is very certain and well known; 
nor is there any wonder in this. The irritability of the 
system, which arises from a new action, of which the 
whole economy partakes, and keeps up a kind of fever, 
is always a critical time of life, and requires a most 
scrupulous attention; not, however, to nostrums; but to 
greater regularity in whatever concerns the affairs of life. 
All rash exposures to cold, long dabbling in cold water, 
indulgence in trashy vegetables, violent fatigue, hearty 
meals of harsh food, rash drinks of cold water, or the use 
of ardent spirits, are to be carefully avoided. Warm 
clothing, regular sleep, reasonable diet and exercise, and 
open bowels are some of the principal means for promot- 
ing health; and it may be added, that at these periods 
women should view themselves, in some measure, as in- 
valids entitled to a little indulgence from all the more se- 
vere duties of life; remembering always to avoid too 
much indulgence; for to want exercise, &c. in a reasona- 
ble degree, is an extreme to be avoided with as much 
care, as the opposite excess: and if such persons are ta- 
ken sick they are to be treated as such, without any parti- 
cular regard to their condition, as respects the menses. 



OF A DISEASED STATE OF THE MENSES. 

SECTION I. SUBSECTION 1. 

Of Painful Menstruation, 

THE disorder of this secretion may be treated of. 

1st. As Painful. 

2t\. Reduced in quantity. 

3d. Excessive, and 

4th. Retained. 

I shall speak of them in the order in which they have 
been enumerated. 

Painful menstruation, as far as my observations ena- 
ble me to judge, is always accompanied either with a 
deficiency of this secretion, or it is accompanied with the 
formation of a membrane, or skin-like substance, which 
is discharged at the usual periods; in this last case the 
menses are sometimes deficient, but at other times it is 
copious. These different conditions do not call for any 
particular difference in the treatment, being but a dif- 
ferent grade of the same disease. 

This disorder of the menses is, perhaps, always an in- 
flammatory disease; but as the inflammation is chronick 
or habitual, we are not to expect to remove it by any 
sudden application of the usual remedies for inflamma- 
tion, as bleeding, active purging, &c. On the contrary, 
use gentle evacuations, during the spells of pain, and in 
the intervals endeavour to raise the system above this 
low grade of inflammatory action, by means of stimulants 
of a particular kind: these are, principally, such as are 
found most useful in chronick rheumatism; and hence, 
there is grounds for believing, that this disease partakes 
of the rheumatick condition. 



©F PAINFUL MENSTRUATION. 425 

I believe, with the great Denman, that no woman in 
the habit of forming this membrane, will conceive; and 
also, that unmarried women or virgins, are liable to this 
disease; but it seems to have escaped the notice of this 
acute observer, that in a great majority of cases of this 
affection, in the unmarried state, that a change of their 
condition is one of the most effectual means for its 
removal. The formation of this membrane is a dis- 
tressing malady in all cases, but is particularly so with 
the unmarried; because severe uterine pains attend, and, 
frequently, partake so much of the bearing down pains, 
and other symptoms resembling labour, that unjust sus- 
picions are often, thereby, excited: indeed, I have met 
with a few cases so strongly resembling abortions, that 
I was led strongly to suspect young ladies, of high re- 
spectability, until my doubts were cleared away, by the 
recurrence of these symptoms, at the usual times or pe- 
riods of menstruation. And I am led, here, to mention 
that such has been the violence of the pain, itching and 
distress, that ill nature or ignorance might have sup- 
posed some violence had been committed, with a view 
of procuring abortion: and further, this membrane being 
detached, but in part, may fall down and close up the 
mouth of the uterus; the menstrual vessels go on to se- 
crete a fluid, which accumulating till the uterus is dis- 
tended, a violent set of symptoms are thus excited; and 
the abdominal muscles being brought into vigorous ac-, 
tion, forces down the coutents of the uterus, with a force 
or violence, which may not only raise suspicions, but 
mayj unquestionably, lacerate the hymen: and hence we 
may call in question the opinion of Denman when he 
says- "the hymen is found generally, if not always, in 
virgins;" and when he says, "the hymen is peculiar to 
the human species, from which circumstance a moral 
writer might draw inferences favourable to the estima- 
tion of chastity in women." 

I am not going to call in question, the propriety of 
considering this a condition which characterizes the vir- 
gin, in general; and therefore, is always a strong ground 
of suspicion when wanting; but to lay this down as an 
infallible criterion, by whidi we are to consign a woman 
54 



4#6 OF PAINFUL MENSTRUATION. 

to infamy, is unwise, unjust, and ill founded. Because 
nature, in her occasional formation of lusus naturce, adds 
supernumerary parts in some cases, but withholds them 
in others; and in both cases, her sportive, or vicious freaks 
invade every part of the body; and if she sometimes forms 
the hymen so strong, as not only to be a sufficient and 
absolute bar against unchastity, but so as to prevent the 
escape of the menses and thereby excites most distressing 
complaints, calculated to raise suspicions, till the real 
nature of the case is known: is it not a fair inference, that 
the opposite, or a very thin hymen, sometimes exists, and 
that the merest trifle may deprive the virtuous woman of 
this common mark of chastity? But more especially 
when disease, such as that above described, happens to 
be associated with a weak hymen, who would risk 
their reputation on this mark of chastity? Women have 
been born, as I have seen, with one mamma, without 
arms; human creatures are born with strong characters of 
the hermaphrodite condition, and after all this, is woman 
to be condemned for want of the hymen? I have long 
thought it a good rule in taking evidence,* to appreciate 
that ichich is related, more by the general character of 
the testifier, than the consideration of an oath, where the 
character was notoriously bad: so, in cases of judging 
the female, we are always to give great weight to the 
general deportment and character, nor venture hastily to 
condemn, on premises which will sometimes be found 
ill grounded. Upon the whole, this mark of chastity is 
to be looked for almost universally, and requires all the 
weight of goad character, and of other circumstances, U> 
support ti.e character: natural defection may, generally, 
have the.testimony of a mother. But humanity pleads 
here for the orphan! I shall conclude by making this fur- 
ther remark; we are beset hy fallibility and defection, of 
various kinds; correct deportment in all the various du- 
ties of life, forms the character; and let this be the test: 
if we have doubts, time will remove them; then let us 
beware lest we condemn the spotless soul of the virgin 
for bodily defection; which she can mostly control, but 
can never form. 



OF THE TREATMENT OF PAINFUL MENSTRUATION. 487 
SUBSECTION 2. 

Of the Treatment of Painful Menstruation. 

In cases of painful menstruation, the following course, 
persisted in for a sufficient length of time, has mostly 
answered my wishes. In the spells of pain, and espe- 
cially as soon as it occurs, hleed either in the arm or foot, 
and, if the symptoms are severe, we may take a pretty 
large quantity, or we may repeat the next day. Take k 
portion of castor oil, or rhubarb, witb a few grains of 
calomel. Use emollient glysters twice a day, and if the 
pains of the uterus are severe, but more especially if the 
formation of skiny substances, are known to take place, 
milk and water, warmed, are to be thrown very frequent- 
ly into the vagina, with a new clean apparatus formed of 
the bladder, &c. in the usual way; and the pipe ought 
sometimes to be entered into the mouth of the uterus, and 
the milk and water injected into its cavity. The mouth 
of the uterus will readily be discovered, by feeling with 
the finger, as it lies loose in the vagina; at its lower roun- 
ded smooth end, an opening can easily and distinctly be 
felt. I esteem the free and constant use of these glys- 
ters, and injections into the uterus, of primary importance. 
Sometimes benefit is obtained from sitting over hot water, 
or bitter herbs boiled in water, &c; but in general, they 
should be avoided, as they predispose strongly to taking 
cold. If the pains continue beyond the third or fourth 
day, notwithstanding these remedies, together with the 
use of a low diet, mild tepid drinks, and rest: anodynes 
are now to be used, and carried as far as may be neces- 
sary for subduing the pain; the opium, or laudanum, 
should be combined with aliHle ipecacuanha, or a double 
quantity of sweet spirit of nitre given with laudanum, 
that is, mix about ten drops of laudanum with twenty of 
spirit of nitre, and take this every three or four hours as 
the case may require. 

In the intervals, between the times of the menses or 
pain, at which time it is no uncommon thing for the pa- 
tient to enjoy good health, active measures should be pur- 



428 OF THE TREATMENT OF PAINFUL MENSTRUATION. 

sued lo remove that peculiar condition, or diathesis, which 
keeps up the disease, and I know of no habit which re- 
quires a greater sameness of treatment. 

The milder cases will yield to the use of the volatile 
tincture of guaiacum, taken in doses of one or two tea 
spoonfuls, twice a day, in a little sweet milk. If the case 
yields not to this remedy, and due attention to the bow- 
els, we must alternate the use of the tincture, with the 
use of calomel and opium: a pill containing two or three 
grains of calomel and half or a whole grain of opium, 
may be taken at bed time; and so soon as the slightest 
soreness of the gums is perceived, we must desist and 
resume the tincture, allowing a day or two for the mer- 
cury to wear off, and thus continue to use these medi- 
cines, alternately, till we subdue the disease. In cases 
attended with marked constitutional debility, we should 
use the iron pills, in conjunction with the tincture; not, 
however, omitting the mercury, unless there be well- 
grounded evidence of scrofula, which should ever be a 
bar to the use of mercury. 

But 1 do not recollect one case of this disease, which 
required the use of chalybeates. The tincture of guai- 
acum is a principal remedy, but in inveterate cases, and 
especially in the married state, I would advise the use of 
mercury, and am well convinced it will sometimes remove 
barrenness, which may be owing to this morbid condi- 
tion of the uterus. I have made it a rule, for the last 
years of my practice, to recommend matrimony in obsti- 
nate cases; and although the disease returned for a term 
or two, they have generally conceived, which effectually 
destroyed this habit. 

In all cases of this kind, a diet reasonably good is ne- 
cessary: all vegetable trash should be avoided: spirits, 
spices, fatigue, passions of the mind, indolence, are to be 
avoided. A milk diet, with light animal food in mode- 
ration, the use of boiled wholesome vegetables, as pota- 
toes, onions, rice, turnips, and good fruit, fresh or 
dried; horseradish, a little garlick and mustard, a little 
whole mustard seed, now and then, will be the most suit- 
able in general. In full habits, a diet somewhat more 
absteminous will be necessary. Exercise, adapted to the 



OF A TOO SPARING CONDITION OF THE MENSES. 429 

strength, is to be constantly pursued, and the cold bath 
may be useful in cases accompanied with direct debility. 

SECTION II. 

Of a too sparing condition of the Menses. 

We meet with two very opposite states of the system, 
which must be attended to in prescribing in those cases; 
and it has been remarked, in the sections treating on 
menstruation, that these derangements of the uterine pur- 
gations are the consequence, mostly, of some previous 
disease. The two opposite states alluded to above, are, 
first, those accompanied with a pale leucophlegmatick 
look, and an evident want of power or energy of the 
whole body, together with a bloated, or lax state of the 
limbs; and with vapours and indigestion. The other is 
accompanied with most of the above symptoms, in a less 
degree, but attended with a florid complexion, and a fe- 
verish disposition, which is readily augmented by fatigue, 
full diet, and such like. 

In the first of these conditions, we are to endeavour to 
rouse the languid action, by tonicks, and particularly by 
chalybeates. The muriated tincture of iron is a valuable 
medicine here; but, 1 have seen great benefit from the 
use of the iron pills, and common bitters. Bark and 
elixir vitriol are also valuable articles, electrical shocks 
may be used occasionally, passed through the region of 
the uterus. 

If these remedies prove ineffectual, the use of com- 
mon madder may be alternated with them: half a dram, 
two or three times a day: or the pills of calomel and opi- 
um, may be given for a few days, now and then, and 
these succeeded by the use of good bitters, as gentian, 
columbo, or the bark; or iron, elixir vitriol, &c. 

A pretty generous but light diet is to be used, and 
exercise, proportioned to the strength, must be persever- 
ed in, avoiding fatigue^ Riding on horseback will gene- 
rally be suitable. A glass of good wine, will be pro- 
per, now and then, and it is essential that the bowels be 



430 OF THE STATE OF EXCESSIVE MENSTRUATION. 

kept open; aloes and calomel will answer best for this 
purpose, in general. 

It may also be remarked, that a gentle emetick, or 
purgative, previous to entering on the tonicks, and also 
once in two or three weeks, will be useful in freeing 
the system from retentions, which may be present, from 
the sluggish state of the vessels aiicj glands of the body. 

In the second condition, with the florid face and fever- 
ish habit, we are to use a diet somewhat reduced, but 
not too low; wine and spirits are to be avoided: exer- 
cise to be recommended; occasional small bleedings, 
and aloetick purges; cremor tartar and nitre; small do- 
ses of ipecacuanha and nitre; an emetick, &c. are to be 
used till the system is a little reduced, when the use of 
bark, and elixir vitriol, bitters, &c. with the occasional 
use of calomel, will generally answer our wishes, by 
due perseverance: for it must be remembered, that chro- 
nick diseases, of which character this partakes, are, in 
general, only to be removed by a pursuit of some regu- 
lar course. 

SECTION III. 

Of the State of Excessive Menstruation. 

This disorder may either be excessive in quantity at 
the usual periods; or from its too long continuance; and 
also from a too frequent recurrence of this discharge. 
But a distinction of more practical importance, is, that 
all these varieties may proceed from opposite conditions 
of the body. They may arise from a laxity, or want of 
tone; or they may proceed from fulness of habit, or from 
a disordered state of the uterine vessels, in particular; 
and both these states of the uterus, and its appendages 
may be of that laxity; or its opposite state of plethora, 
or fulness, or increased action. 

The indications of cure in these cases, are to be found- 
ed on the state of the system: if there be debility and 
laxity of the habit, such means are to he used, as are 
calculated to give strength and tone to the system, as 
bitters, elixir vitriol; aud, in the spells, omates with a lit- 



OF KETENTION, &C. OF THE MENSES. 431 

tie white vitriol may be taken, and rest must be enjoined. 
The application of cloths wrung out of cokl vinegar, ap- 
plied once or twice a day, will answer a good purpose. 
These cases in general, will not bear iron. But I think 
the bark, mixed with about half its quantity of creuior 
tartar, and some mild aromatick, as a. little alspice, or 
cloves, is one of the best tonicks we can give in the in- 
tervals. 

When it arises from plethora or fulness, we must bleed 
and purge moderately, give occasional emeticks; but if 
the health is not much affected in the intervals: we may 
in general, confine our attention to the spells of the dis- 
charge, and here, we should bleed, purge, give nauseat- 
ing doses of ipecacuanha, and if these do not succeed, 
we may now apply cold bathing to the pubes, and abdo- 
men; give opium and nitre. In the intervals cremor tar- 
tar, taken pretty freely, will in general answer a good 
purpose. But in many cases, regular exercise, sleep, 
diet, temperance in drinking, &c. will restore the health; 
for in most cases it arises from irregularity in some of 
these things, or from inattention to dressing suitably 
warm: and to pay more attention will often be sufficient 
to banish the disease. 

SECTION IV. 

Of Retention, or total Absence of the Menses. 

This may be reckoned, in some measure, as of two 
kinds, such as sometimes occur in women who have 
menstruated, but afterwards, from some disease, it has 
been checked; or such females as go beyond the usual 
term of its appearance. 

In all these cases, we are to pay especial regard to the 
general health; while that is good, we should by no 
means interfere; for we may much more easily do mis- 
chief than good. It will be advisable, however, in ge- 
neral, for such females to view themselves as invalids, 
in some degree, and therefore it behooves them to ob- 
serve unusual care, and avoid all excess or irregularity. 
If disease come on, they arc to treat it according to the 



43& OF THE FINAL CESSATION OF THE MENSES. 

symptoms, which in full habits will consist of moderate 
evacuations by bleeding, purging, &c: and in the op- 
posite or low state of the system, iron, bark, elixir vitri- 
ol, and other tonick or strengthening remedies, &c. 

section v. 

Of the final Cessation of the Menses. 

Many women are under great apprehensions about the 
period of the final cessation of the menses: and I verily 
believe they suffer more harm from their groundless ap- 
prehensions, than from the disorder. They seem to for- 
get, that, it is as natural an operation of the body, for the 
menses to cease at a certain period of life, as it is for them 
to exist at another period. 

I have said, in section third of this chapter on the dis- 
eases of women, that such women are invalids generally; 
but let it be remembered, that they are not to tamper 
with medicine without cause, nor are they to view every 
disease, with which they are attacked, as proceeding from 
this cause, which is too often the case, and leads to im- 
proper views, and prescriptions; because they are al- 
ways founded on false notions about this supposed dis- 
eased state of the menses. 

And they had better, in general, direct their attention 
to the state of the menses only when it is excessive, or 
painful; in these cases, rest, mild glysters, and a mode- 
rate bleeding, in full habits, will answer every purpose; 
in weakly persons, rest, glysters, and a few anodynes, 
will answer every reasonable expectation. 

If they are otherwise diseased, medicines, &c. are to 
be used according to the nature and state of the disor- 
der; and here, in all severe cases, a physician of expe- 
rience should be called in. 



OF PREGNANT WOMEN. 

SECTION I. 

Introductory Remarks. 

TO describe all the diseases which may occur in the 
state of pregnancy, in child-bed, &c. with the various 
means necessary for their removal, and convey the ne- 
cessary anatomical knowledge, belongs most properly to 
books on midwifery, and requires room which cannot 
be bestowed on it in this work. I therefore shall but 
briefly mention some of the peculiarities of the pregnant 
woman, and endeavour to correct a few errours which 
prevail, pretty generally, respecting their condition. 
There have been warm disputes tending to prove, or dis- 
prove, the idea of pregnancy being a state of disease; 
but here, as in most other things, human actions are car- 
ried to extremes. 

One set would have a woman all disease from con- 
ception to the completion of her parturient term, while 
another would argue that so far from pregnancy being a 
disease, such women are, in general, more healthy and 
exempt from disease on this account; and that a woman 
left to herself would seldom, if ever, perish either from 
disease during pregnancy, or in the parturient state, un- 
less it be from disease or accidents, which might arise 
independently of pregnancy. 

I believe the truth lies between these two extremes. 
Pregnancy is not a disease, but it is a predisposition to 
disease, and predisposes to a peculiar set of maladies; 
while the woman at the same time is liable to diseases 
which affect them in common with other women, or 
mankind in general. But this predisposition is not a 
necessary condition of the pregnant woman^ but ari- 
55 



4&4< ON THE ADVANTAGES OF EXERCISE TO WOMEN. 

ses from her infirmities, which often spring from refin- 
ed life. 

In the first edition of this work, some reflections were 
offered on the curse pronounced on the conception, &c. 
of woman, at the fall of our first parents. But, after 
more mature reflection, I have thought advisable to omit 
them in the present edition, because it is a subject 
which, more properly, belongs to books on midwifery. 

SECTION II. 

On the Advantages of Exercise to Women. 

Independent of all reasoning on this subject, I think 
experience plainly teaches us, that pregnancy is not a 
disease, and it is probable that with all the strength of 
constitution which women do sometimes possess, there 
is not even any particular tendency to disease. But as 
we find women in general, they carry during their preg- 
nancy such a tendency, and are also liable to many inci- 
dental disorders in the term of parturition; by which I 
mean, that period which begins with labour, and ends 
when health has been regained. 

This view of the case is of vast importance, as it leads 
to admonish the mother, that as the stamina, or sound- 
ness of constitution of her daughter is established by all 
the usual means bestowed upon her from infancy, so will 
be in the main, the future hopes of her daughter. 

But it is especially to be recollected, that pregnancy 
and parturition is to the woman entirely animal; and if 
she loses some of those animal advantages which the 
women of the forest possess, she is amply compensated 
for a reasonable weakness of body, by the manifold en- 
dearments and blessings of refined life. This weak- 
ness of constitution must be reasonable, or women 
loses all the greater blessings of life; for which all the 
learning and embellishments of the mind cannot com- 
pensate, and therefore in rearing these tender plants, let 
especial care be taken to unfold the body by sufficient 
exercise. 



DISEASES OF GESTATION, &C. 435 

Let them use their own limbs and not those of ser- 
vants; these form, if duly expanded and strengthened by- 
use, a support for them in the hour of travail. The 
limbs of the latter, like the shattered reed, may sigh to 
the wind, but sighs avail not in the hour of trouble! nor 
are we rashly to call on heaven for aid. The ways and 
means were originally measured out to mankind, and 
they who neglect the means, invoke an insulted heaven 
in vain! 

If your situation requires the avoidance of the common 
duties, on the part of your daughter, let walking, danc- 
ing, and riding, be enjoined as an indispensable duty. 
And rather forego some of the softer delicacies, or ex- 
treme refinements than risk the health of your posterity. 

And it will be found in general, that the jolly girl who 
can crack the whip, and mount the prancing but safe 
horse; leap the ditch; or drive the carriage, &c. will not 
only be more acceptable to the man of sense, but the very 
consciousness of her own strength, will paint her cheeks 
with the bloom of health; while the woman, all sensibili- 
ty or refinement, conscious of bodily weakness, startles 
at her own pale face, and as she applies paint for weak- 
ness, spoils the work with her own tears! 

SECTION III. 

Diseases of Gestation, and of the usual Remedies. 

SUBSECTION 1. 

Of the Diseases of the early Months, 8£c. 

It may with truth be said, that most of the diseases 
with which pregnant women are sometimes affected, oc- 
cur at all other periods of life: but there are a few disor- 
ders which are evidently the consequence of an increased 
irritability of habit, and which arise from the stimulus 
of the active uterus. There is, however, no necessity 
for distinguishing these from those which are more inci- 
dental: for I have elsewhere endeavoured to maintain 



436 DISEASES OF GESTATION, &C. 

that they are all incidental, as respects the woman of 
complete animal powers. 

The most usual disorders which attend the early 
months, are sickness at stomach and vomiting; heart- 
burn; irregularity of the bowels; longings; swellings, 
and pain in the breasts; hysterick fits; wrong position of 
the womb. 

SUBSECTION 2. 

Sickness and Vomiting of Pregnant Women. 

This arises sometimes in very opposite habits: in those 
of good habit, if there be a feverishness, or flushing of 
the face, or bleeding at the nose, with much straining to 
vomit, and general evidence of fulness, we should bleed, 
use a light vegetable diet, and the most cooling drinks, 
and keep the bowels open with the mildest purgatives or 
injections. When these symptoms occur in reduced ha- 
bits, attended with languor, and a disposition to sweat, 
&c. a light nutritious diet, the moderate use of good wine, 
pleasant bitters, as bark, columbo, &c. will be advisa- 
ble. If the case is obstinate, in both states of the sys- 
tem, unless extreme weakness forbids, a very gentle erne- 
tick of ipecacuanha will be advisable. Opiates, parti- 
cularly in weakly habits, will often be found useful; or an 
anodyne plaster may be worn over the stomach. Exer- 
cise, accommodated to the circumstances of the case, is 
never to be neglected. 

subsection 3. 

Heartburn of Pregnant Women. 

This disease is common at every period of pregnancy; 
but as it often occurs early, I have placed it here. If 
attended with costiveness, magnesia and rhubarb will 
mostly answer our wishes; a little milk and lime water, 
or a few peach kernels; a little soda water; calcined 
magnesia; or a little nice gum arabick dissolved in wa- 



DISEASES OF GESTATION, &C. 437 

ter, and made tart with lemon acid and sugar, and taken 
in small quantities occasionally, will be found useful. 

SUBSECTION 4. 

Irregularity of the Bowels of Pregnant Women. 

The most usual state of the bowels, when disordered 
in the early months, is a looseness. If it is accompanied 
with sick stomach, a gentle emetick of ipecacuanha should 
be taken: and the foulness which accumulates from an 
increased action or excitement of the bowels, should be 
removed by the use of magnesia and rhubarb, or best 
castor oil, or the epsom salts. 

It these do not succeed, there would still be no safety 
in using opiates, or astringents, unless the habit is redu- 
ced; and in this case they are indispensably necessary. 
The use of glysters of starch and water will answer a 
good puspose, where there is much heat and pain in the 
bowels; and if the habit is reduced, laudanum should be 
given in the starch glysters; and this will be the best 
mode of administering opiates. 

subsection 5. 
Unnatural Desires or Longings of Pregnant Women. 

Longings have been a source of much confusion and 
diversity of opinion; some arguing that they might even 
influence the welfare of the child; others denying any 
possibility of such influence, while many have been wa- 
vering between these opposite opinions, and of course 
have no settled opinion about it. 

I think it highly probable, as suggested by the cele- 
brated Denman, that the first opinion, or that which holds 
that even the child was liable to suffer from this longing, 
arose from good nature or humanity, at a time when the 
female was degraded, and held the place of the servant, 
instead of that of the Avife of equality. And was kindly 
intended to relieve them of a part of the toils which 
unpolished or unenlightened man is known to exert over 
the female in every country. 



438 DISEASES OF GESTATION, &C. 

But these causes have ceased to operate, generally, in 
our country. It is time to banish such unfounded opin- 
ions from every female mind; for it is not only an er- 
rour as commonly viewed, but leads often to mischief, 
by impressing the mind with anxieties injurious to health. 
Hence it maybe said, longings lead to disease, because 
they disturb the mind; and a disordered mind will prey 
upon the health, whether arising from real or imaginary 
evils. 

Experience warrants fully the belief, that longings cau 
never injure the mother, or child; on the contrary, an in- 
dulgence or gratification of such desires is highly detri- 
mental, and should be viewed as a disease of the sto- 
mach. 

Tbe woman nearly in a state of nature, probably knows 
nothing about these longings, and when they occur in ci- 
vilized life, they call for the aid of medicine, like every 
other disease. It may be remembered, however, that in 
some rare cases where the patient is much debilitated, 
appetites seemingly somewhat extravagant, are to be in- 
dulged reasonably, but in no greater degree on account 
of the pregnant state, than in any other condition of the 
diseased body; and therefore, the pregnant woman who 
otherwise enjoys health, should curb every unnatural or 
unreasonable propensity. 

A gentle emetick, or a few doses of epsom salts, or 
rhubarb und megnesia, will generally, with temperate 
diet, relieve those cravings. I am clearly of opinion, 
that the increased irritability of habit which attends preg- 
nancy, calls for, and strongly claims indulgence in every 
thing relating to life, but, the golden rule here is mode- 
ration. 

subsection 6. 

Swellings, and Pain in the Breasts of Pregnant 
Women. 

A remarkable sympathy or connexion exists between 
the breasts and uterus; and, in particular, all the natu- 
ral and healthy operations of the impregnated uterus are 



DISEASES OF GESTATION, &C. 439 

felt in the mammae; pain and swelling is generally pre- 
sent at an early state of pregnancy, but seldom require 
any thing more than leaving the breasts room to dilate 
freely; and living a little abstemiously, carefully avoid- 
ing stays, &c. A little warm oil may be rubbed into the 
breasts, once or twice a day, if the pain is considerable; 
or if still more severe, a bleeding and a, cooling purge or 
two, may be necessary. 

SUBSECTION 7. 

Hysterick Fits, and Faintings of Pregnant Women. 

These sometimes occur in the early months in irritable 
habits: if they arise from the irritation of the distending 
uterus, they are seldom if ever attended with any dan- 
ger. They are mostly temporary, but if severe, remedies 
must be applied, suited to that condition of the system, 
which happens to be present, for these disorders may 
arise in opposite conditions of the system. 

If the habit is full, we must advise bleeding, and re 
lieve congestions of the bowels, by cooling physick or 
glysters. 

If the habit is weakly and irritable, opiates, with due 
attention to the bowels, will answer; or other antispas- 
modics, as assafoetida, ether, &c. may be used. 

Particular attention is to be paid to the mind, and ev- 
ery reasonable allowance made for its increased irritabi- 
lity, but let no weak minded woman claim to herself un- 
due allowance, in this respect; prudence here, is almost 
every thing, and therefore, every prudent woman, while 
she receives indulgence, is to make it her constant study, 
to reciprocate the favours of good nature; and by endea- 
vouriug to please others, she can never fail to please her- 
self. 



440 DISEASES OF GESTATION, &C» 

SUBSECTION 8. 

Wrong Position of the Womb. 

About the fourth month, the womb begins to rise from 
its situation in the pelvis, and to mount slowly into the 
abdomen. If it happens to lose its proper position, so 
that its longest diameter presses on the rectum and blad- 
der, unpleasant symptoms are excited, as bearing down 
of the womb, tenesmus, inflammation of the bladder, ob- 
structed urine, and obstructions of the bowels. 

If these symptoms become troublesome during the 
fourth month, or a little sooner or later, the patient can 
in geueral determine, by feeling with the fingers, whether 
the uterus is wedged or confined in the pelvis: if it is, 
rest, in time, will often alone remove the complaint; but 
if it has advanced, the case becomes critical, and requires 
advice. 

The womb is to be replaced, by gentle pressure up- 
ward, and the patient to keep pretty much in a horizon- 
tal position. But sometimes the uterus is not easily rai- 
sed, and the case becomes urgent from the confinement 
of the uterus, &c. in this case the catheter \s to be intro- 
duced, to draw off the water, and glysters must be given, 
to open the bowels; and if the symptoms notwithstand- 
ing rumhigh, we are by all means to bleed, enjoin a low 
diet, and then give gentle anodynes: but this case is men- 
tioned most, witli a view to put the woman upon her 
guard; and when it occurs, the best advice should be ob- 
tained without delav. 



OF THE DISEASES OF THE LATTER MONTHS, &C. 441 
SECTION IV. 

Of the Diseases of the Latter Months, §*c. 

SUBSECTION 1. 

Of Costiveness, 8£c. of Pregnant Women. 

I shall here speak briefly, of some of the most com- 
mon diseases which trouble women, in the latter months 
of pregnancy. These are costiveness; piles; swellings 
of the legs; pains in the back, &c; cough, and difficult 
breathing; cramps; colick-pains; suppression of urine, 
and incontinence of urine. 

It is probably true, that pregnant women are less in- 
jured by costiveness, than in any other condition of the 
body, and in general, if no inconvenience is experienced 
from it, they may leave the case to nature, observing ev- 
ery necessary regularity. But if inconvenience seems to 
arise from it, injections, or epsom salt, or castor oil, 
should be taken to remove it. 

Reasonable exercise in general, with a vegetable diet, 
and the reasonable use of ripe fruit, will be found useful, 
provided no extreme debility of the constitution forbids; 
if this be the case, a light thin diet, consisting a good 
deal of fresh animal food, will answer a good purpose. 

SUBSECTION %. 

Piles, or Hemorrhoids. 

This is a common complaint in the latter months, but 
no particular difference is necessary between this disease 
in the terra of pregnancy, than at other times: the reader 
is referred to the article on this disease. 

56 



442 OF THE DISEASES OF THE LATTER MONTHS, &C. 



SUBSECTION 3. 

Swellings of Legs, Thighs, and Belly, of Pregnant 

Women. 

These swellings are only particularly entitled to no- 
tice, when they become considerable. 

If they occur in delicate habits, rest, frequent gentle 
rubbings with a soft flesh-brush, or smooth flannel, are 
principal remedies, but still exercise is by no means to 
be wbolly avoided; the bowels are to be kept open, and 
the diet suited to the circumstances of the case. 

If there is a fulness, with pain, we should bleed mode- 
rately, give a gentle purge, and enjoin a low diet; and 
accommodate the exercise to tiie strength of the patient, 
not forgetting that moderate exercise is indispensable in 
all cases where it can be borne. 

subsection 4. 
Pains in the Back, Belly, §*c. 

These arise from the pressure of the distended and 
heavy uterus, and will yiejd to occasional small bleed- 
ings; suitable diet; open bowels; and opiates, regulated 
according to the constitution of the patient. It is espe- 
cially to be recollected b\ such patients, that they should 
change their positions frequently, as well during the 
night as during the day; and, in general, they should 
avoid much stooping. 

subsection 5. 
Of Cough and Difficulty of Breathing. 

These are complaints which are not often removable 
by any means till after delivery, when they will cease of 
course. They arise from the confinement of the chest, 
and this confinement is occasioned by the uterus, which 
now distends the whole abdomen, so as to press power- 



dF THE DISEASES OF THE LATTER MONTHS, &C. 44& 

fully upwards, and thus confines the diaphram, and the 
viscera of the chest. 

If the difficulty of breathing is great, occasional bleed- 
ings, with low diet, in full habits, will have a good ef- 
fect, but in reduced habits we must bleed wUh caution; 
mild opiates, combined with sweet spirits of nitre, may 
have a good effect in these cases. For the cough, the 
same remedies as are recommended for the difficult 
breathiug, will usually answer. It is especially neces- 
sary in these cases, for the patient to breathe a wholesome 
air; their bed-rooms should be airy; they should sleep 
alone, avoid curtains about the bed, and in the day care- 
fully avoid crowded or sultry places. Reasonable ex- 
ercise, with a diet as low as can reasonably be borne, 
may be expected to have a salutary effect. 

subsection 6, 
Cramps of Pregnant Women. 

These sometimes occur in the legs, thighs, &c. in the 
latter months; and especially at night. This affection 
must be treated on general principles: bleeding; laxa- 
tives; low diet, followed by opiates, may be used in full 
or good habits. In opposite habits, rubbing the parts 
with opodeldock, or ether and laudanum; and the use of 
opiates, and a spoonful of whole mustard seed, taken 
in molasses at night, together with a reasonable diet, 
will seldom fail to remove this severe complaint. Ex- 
ercise and dry rubbings frequently repeated, must not 
be omitted. 

subsection 7» 

ColicJc-Pains of Pregnant Women. 

These sometimes are severe, and resemble, in a, good 
degree, the pains of labour. They may arise from the 
irritation occasioned by the uterus confining the viscera, 
but are often the consequence of eating unsuitable diet, 
or costiveness may have a share in its production. If 



444 OF THE DISEASES OF THE LATTER MONTHS, &C 

costiveness attend, this is carefully to be removed, but if 
the symptoms are urgent, opiates are to be administered 
freely; if fever occurs or is present, bleed. Glysters are 
to be given occasionally, while any tendency to these 
pains continues, and especial care is to be paid to the 
diet, and drinks, which are to be plain, and taken more 
frequently than usual, but upon the whole, the diet should 
be sparing. 

If the colicky pains are obstinate, and we are not well 
satisfied the bowels are completely opened, an examina- 
tion must be had of the rectum; this can be done by in- 
troducing a finger into the vagina, to ascertain whether 
there be not indurated feces confined in the rectum. For 
we are assured by Denman, that a retention of the feces 
sometimes occurs even where the bowels seem to be open, 
which may be owing to a narrow passage, which permits 
the thin feces to pass without removing the more harden- 
ed part. If such balls or feces are found on feeling, they 
must be removed by the finger, passed into the vagina, 
or a smooth instrument, in form of a scoop, must be pass- 
ed up the rectum to bring down the confined matter, other- 
wise fatal consequences may occur from mortification. 
Purgatives are by no means to be given if we are aware 
of the existence of this complaint. They may in gene- 
ral be removed by taking a tube about twice the length 
of the usual ivory glyster pipes, and passing it careful- 
ly and gently through the feces, which can be felt, and 
as we pass among it with the pipe, let the usual con- 
tents of an injection be passed up. By repeating this a 
few times we will probably generally succeed, but great 
Caution is necessary not to excite any pain, or use any 
violence. 

subsection 8. 

Of Suppression of Urine. 

Little can be done in this affection till the woman is 
delivered, when it will cease, provided it has not been 
improperly treated. \ll that should be done in these 
cases is to endeavour carefully to evacuate the urine by 



OF PARTURIENT WOMEN. 445 

laying down, and pressing up the weight of the belly, as 
often as a desire to pass urine occurs. If this will not 
succeed, a catheter should be used as often as necessary, 
and in general this instrument may be used without 
hazard by females of reasonable discernment. But it 
would be best, in all such cases, to get the best advice. 

subsection 9. 
Of Incontinence of Urine. 

This mostly arises from neglecting the case of suppres- 
sion, and is to be removed by the same means. When 
this cannot be effected, the patient may be rendered more 
comfortable by preserving dryness of her under clothes, 
by wearing a large sponge, or several folds of flannel, 
which will require frequent removal. 



OF PARTURIENT WOMEN 



SECTION I. 

Introductory Remarks. 

AMPLE instructions for parturient women are only to 
be expected in systems of midwifery; I shall, therefore, 
but briefly, point out a few errours which prevail, and 
conclude with a few general instructions. 

Incalculable mischief arises from superstition in all the 
affairs of mankind; but when it operates on the mind 
of the parturient woman, it is doubly cruel and destruc- 
tive; because, in refined life, they are always brought 
low, and require all our kindest attentions to support the 
trying hour of travail. 



446 OF PARTURIENT WOMEN. 

Superstition may be defined thus: a propensity of the 
mind to acknowledge things represented by others, with- 
out due caution in requiring the data, or grounds, on 
which things, or reports, are founded: hence, this lazy, 
low-bred jade, blind and vicious, is maintained by two 
propensities of the mind; and both of these propensities 
are vicious in their nature. The first of these propensi- 
ties is a vain desire to obtain credit for superiour sagacity; 
and this begets another propensity in the mind, which is 
a desire to hide our weakness or ignorance; and so pow- 
erful is this propensity, that few ignorant persons can 
veil their ignorance in silence; on the contrary, in pro- 
portion to their ignorance, so will they be more loqua- 
cious; and as the most common thinker wishes to avoid 
detection in his sayings, they are ever anxious to propa- 
gate those kind of notions which are difficult to detect; 
otherwise they have to dread, not only a discovery of 
their ignorance, but are brought under the imputation of 
falsehood. 

The other propensity is that lazy habit, too common, 
of admitting reports or sayings without examining the 
grounds on which they are predicated; and it is vicious, 
because as rational creatures we owe it to ourselves, to 
society, and to the. Creator, to exercise our reasoning 
powers; and a first or leading aim in ratiocination is to 
reject such things as ought to be accompanied with facts, 
unless those facts are obvious; and, in the second place, 
those things which admit not of demonstration require 
all the force of long experience, or the most careful ex- 
amination of their results. 

A destroying monster has gone forth to slay parturient 
women, under the name of leap year. And, reader, 
can you hesitate to believe, that an impression of this 
kind may and has done vast mischief, although it is 
wholly imaginary. Thus, some would-be-wise person 
starts an idea that leap years are fatal to parturient wo- 
men: a pregnant woman anticipates the fatal blow at 
the end of her pregnancy, and the constant impression 
of fear seriously impairs the constitution; and as she was 
weak enough to give up her mind to superstition, with- 
out due examination, she often views things, the most 



OP PARTURIENT WOMEN. 44tf 

common, as ominous, till every breath of wind, or sound 
at night, rings the alarm, until she, like the frightened boy 
pursued at night by ghosts, at every accession of speed 
is pierced with new horrours, and feels the grasp of the 
pursuer at every spring. Every energy of the animal 
power are under heavy contributions in the case of the 
boy, and at length he arrives exhausted at his home, and 
congratulates himself on the happy escape from the man 
without a head, &c. But lo! the light of morn dispels 
his fears, and retracing the road of terrours, he meets 
a stump! a bush! a rock! and finds, indeed, it was with- 
out a head. And that he has acted a part which would 
have ealled forth plaudits for his speed, but which dis- 
graced the weak mind. 

Let the pregnant woman spurn from her confidence 
the weak, who would thus ignominiously set her mind 
to fly from point to point, like the frightened boy, but 
with less hope of escape. The boy runs for home, and 
hope supports the trembling frame; but alas! whence 
shall weeping woman derive her hope? — Like the unan- 
chored ship amid the troubled waves, she is loaded with 
despair! This is a species of fear which pursues its 
victim by night, and in the light of day; but the light 
of reason dispels the gloom, and brings conviction to 
the mind that this report is founded on ignorance, and 
ought to suffuse the face of the busy tattler with shame, 
for propagating so cruel, and so unwise, and impious 
a tale. 

I shall advance but two positions to clear away this 
demon, of human creation. 

1. Nothing is more invariably true, than that the ways 
of providence are inscrutable, and particularly veiled in 
that kind of mystery, which prevents mankind from pry- 
ing into futurity, and we are even expressly told, we 
are not to look for signs and wonders. This alone makes 
man's abode here tolerable, for, if the Deity had allowed 
that we should foresee events, an entire new order of 
things must arise, or man soon would perish under the 
load of anxiety which he might anticipate. 

&. All the supposed mystery of a leap-year's in.hience 
falls prostrate before the simple fact, that it is wholly ar- 



448 OF PARTURIENT WOMEN. 

tificial, and established by the ingenuity of man. TimQ, 
as respects created bodies, runs from beginning to its ter- 
mination, and as respects this world, the various parts 
of it have days, and seasons, regulated by their situations, 
as respects latitude, longitude, &c: and the world exis- 
ted for thousands of years, before mankind discovered 
the convenience of dividing time, so as to square their ac- 
count of it once in four years. But people have been 
found making these periods of different lengths, thus we 
may have two days at the end of eight years, or three 
days at twelve years, or we may even go on until we add 
an additional month; so that there can be nothing in this 
notion of leap years, for they are arbitrary divisions of 
time, made by modern astronomers. - 

There are many other things which are held as omi- 
nous, but which would crouch before the test of reason. 
But all of them may exert a baneful influence, by work- 
ing on the imagination, for here to imagine, is to admit, 
and to admit, is to bring about the consequences, of such 
admission, whether the fancy is founded on false or true 
premises. 

Let me remind the pregnant and parturient woman, 
that Revelation pointedly discloses the protection of the 
Supreme over the widow, and the orphan; and it is said 
"suffer little children to come unto me, for of such is the 
kingdom of heaven." And shall we believe that, that 
merciful God who protects the widow and the orphan, 
and whose kingdom fosters "little children," will forsake 
the pregnant or parturient woman. 

At each addition to the flock of little children a Sa- 
viour smiles, and a virtuous woman who is the instru- 
ment of this increasing flock, of immortals, while she 
walks in that becoming humility to the divine laws which 
is required of all, may derive fortitude from the circum- 
stance that she is under double protection, first she may 
reasonably look for equal protection herself, and more 
especial protection for the child of her womb. While 
she walks then in the narrow path of virtue, let her feel 
full confidence that she is especially protected; and if a 
neighbour sinks away at such a time, it can have no con- 
nexion with her. 



OF PARTURIENT WOMEN. 449 

From the commencement of life to old age, we are all 
liable to death; when or where it is to happen has been 
kindly concealed. Let us then be prepared, and without 
fear, or forebodings, discharge the duties assigned us; 
for it is both unwise and impious to apprehend danger 
when it is not actually present. 

t 

SECTION II SUBSECTION 1. 

Of the diseases of Parturient Women. 

I come now to mention a few of the diseases which 
sometimes accompany parturition, and to suggest a few 
cautions and remedies. A woman may approach the 
parturient bed without apprehension, for it is a natural 
process, and the same protecting power which brought 
themselves into being, will sustain the approaching child 
and its mother. But to lose confidence, and hope, in 
the hour of travail, is to incur danger, for fear often be- 
gets evils, which it created. 

subsection 2. 

Of Chills. 

Considerable chills often accompany the first symp- 
toms of labour, these are best let alone; or if severe, a 
little weak warm tea may be taken. But wine, spirits, 
&c. which are often taken at such a time, are extremely 
pernicious; they may lead to inflammation of the uterus, 
to fevers, and many other evils. 

SUBSECTION 3. 

Of After fains. 

Almost every female midwife, and especially the igno- 
rant, are provided with remedies for after fains; and of- 
ten give heating cordials which do much mischief. No- 
thing is necessary but to keep the bowels open, with mild 
injections, or best castor oil, or rhubarb with a little 
37 



450 OF PARTURIENT WOMEN. 

senna and coriander seeds; and as often as the pains are 
severe, take twenty-five to thirty-five drops of equal parts 
of sweet spirit of nitre and laudanum. 

subsection 4. 

Of Puerperal Fever. 

If fever comes on before the third day, or after milk 
is formed in the breasts; or if it at any time runs higher 
than we may reasonably expect from the milk fever, but 
more especially, if it is accompanied with soreness, or 
constant pain in the lower part of the belly, the best ad- 
vice should be got. If advice is not to be had, in reason- 
able time, we should bleed and repeat according to the 
violence and obstinacy of the pain and fever; cooling 
drinks, mild purges, and cooling powders of nitre and 
cremor tartar should be taken. 

The diet must be very low, and free admission of air 
allowed, and strict attention to cleanliness by frequent 
changes of clothes, &c. 

For inflammation of the breasts, or sore nipples, see 
the article on inflammation. 

subsection 5. 
Of Vomiting. 

Vomiting often attends labour: in general it is not at- 
tended with danger, and requires nothing but a little 
chamomile, or nice green tea, to empty the stomach. If 
it becomes severe, a few drops of hartshorn may be ta- 
ken, and in weakly habits a few drops of laudanum. 

SECTION III. 

Concluding Advice to Parturient Women. 

Let it always be remembered, that prevention is bet- 
ter than cure, and therefore, it is a matter of the utmost 
importance to procure the advice and assistance of the 



OF PARTURIENT WOMEN. 451 

most skilful. A good deal of diversity of opinion pre- 
vails respecting our choice of men, or women, midwives, 
but this is an inquiry without reason, for the question is 
not of what sex is the practitioner, but what are their 
qualifications? 

It is a lamentable fact that women midwives in gene- 
ral, commence practice without any instruction, and what 
is worse, few women of intelligence, or standing in soci- 
ety, will engage in this practice, for it is really viewed 
as mean and only worthy the attention of the meanest 
and most ignorant. 

Strange infatuation, that in an enlightened country, 
the life of the mother, and of the heir, is committed to 
the hands of ignorance! It is no uncommon thing for 
the kind husband to watch the sick bed of his wife, and 
while he freely calls in two or more physicians, to her 
assistance, still feels all the tortures of anxiety; yet when 
that same lovely woman is about to take the bed of tra- 
vail, and has her child's life in some measure hazarded 
with her own, that same husband commits all to the care 
of some old woman, who is not only, perhaps, the most 
ignorant woman in the neighbourhood, but often nearly 
blind, and unhandy from age: and what is worse, most- 
ly feels hostile to practitioners of superiour judgment, 
and will often make the most daring efforts in order to 
expedite, lest they may be thought unskilful, or some 
other practitioner called in. 

It seems strange how so important an affair should 
have become so degraded in the eyes of the publick. A 
woman of respectability would disdain the name of gran- 
ny, for female practitioners are held in equal contempt 
with the servant. A little reflection will convince us that 
this is all right, and that the ignominy is not attached to 
the profession, but to the professor. No wonder a gran- 
ny is held as a low member of society, for the term gran- 
ny is synonymous with poverty, and w r ith ignorance. 

Reader, from actual experience I can most truly say, 
I have seen such iguorance, daring adventure, actual 
mischief, &c. that, when I survey in imagination, over the 
face of this immense country, the danger, the suffering, 
and the actual destruction of our lovelv females, and of 



4*52 OF PARTURIENT WOMEN. 

our infants, my eyes grow dim, and my heart swims in 
sorrow, and I might truly exclaim, oh! that mine head 
was a fountain of water, and my eyes a flood of tears, 
that I might weep day and night, for the slain of the 
daughters of my country. 

A detail of what I have seen in country practice, would 
sicken the feeling mind; few can imagine the danger and 
injury which our women and infants suffer. 

In the lower ranks of life I can readily suppose that 
some repugnance is felt against, male practitioners, hut 
where the mind has been enlightened, and where none 
but men of good character and of education, would he 
employed, such feelings can have no share in the things 
which conspire to keep up objections to men accoucheurs. 

After much reflection, I am clearly of opinion, it is in 
good measure owing to meanness; an old crippled wo- 
man can be got for a dollar or two; the doctor will charge 
from five to twenty. What a saving? the wife of your 
bosom once in a year, or mostly every second year, sub- 
jects you to this expense. And is it so, that for the paltry 
consideration of a few dollars, you will subject a wife, 
and a mother too. to the care of stupidity, often blended 
with the most daring temerity. 

But I forbear: each one must know best his reasons 
for countenancing this cruel degrading practice. I beg 
leave, however, to admonish every man who regards the 
welfare of his wife and offspring, to make it a matter of 
conscience to admit none to the parturient chamber but 
practitioners of probity and of experience. 

And it is the height of folly, to suppose an old woman 
is qualified to take charge of the health and life of your 
wife and child, because she is a mother: common cases 
of midwifery afford no instruction; and, therefore, a wo- 
man might have seen scores of children born, and be 
wholly incompetent to the management of the slightest- 
deviation from the most common cases. 

Let it not be supposed, from these remarks, that I 
view child-bearing as so very dangerous as to call for any 
particular skill in general; on the contrary, assistance is 
seldom necessary, and it is by doing too much, that ig- 
norant persons do most injury. 



OF PARTURIENT WOMEN. 453 

Accidents do sometimes occur, and very often the 
merest trifle is turned into a stale the most dangerous. 
in the hands of ignorance. What anxiety! what pain! 
what fear might be prevented by employing the most en- 
lightened and experienced practitioners in all parturient 
cases. What hope! what fortitude! and what power 
consequential of this hope and fortitude! may suffering 
woman derive from the presence of a practitioner of rec- 
titude, of humanity, and of experience! The mind sup- 
ported by this honourable confidence, carries the tortur- 
ed body through the troubled waves, and if ideas of dan- 
ger would assail her trembling heart, she drops her an- 
chor at every swell. The means are present, if heaven 
bless them, for what more can she wish? How different 
is the case of her who is committed to the care of igno- 
rance! Here, the heart trembles at every pause, and the 
suffering woman, as one without hope, looks out for ap- 
proaching danger, and should it be announced, what must 
be her suffering! 

Imagine a woman tortured, reduced and feeble, who 
has been brought thus low in the hands of ignorance, 
abruptly told she must send for the doctor; and what 
may we not suppose her anguish, more especially if she 
be a mother. What anxiety, w halt-danger might have 
been saved by having called in a practitioner of judg- 
ment at first! 

Oh! that some meek spirit would hover over the land, 
and with all the powers of love, invite every man and 
woman to unite, wherever honourable love exists, in re- 
vising and correcting this cruel custom of our country, 
Shall the American boast of the fair women of his coun- 
try, while they are thus neglected? Rise as sons of li- 
berty, and weave the shield! I plead for your mothers 1 
sisters! and daughters! shield them from suffering! guard 
them from ignorant midvvives! 

It remains to offer a few words of advice respecting 
the necessary preparation, and of the most suitable ma- 
nagement, during the child-bed state. 

Great exertions are made by people, in the country. 
to procure cordials; wine, rum, spirits, whiskey, toge- 
ther with cheese, cinnamon, nutmeg, &c. as though they 



454 OF PARTURIENT WOMEN. 

intended to worship at the shrine of Bacchus. Would 
that there was half the anxiety about getting good ad- 
vice, that there is about procuring these unnecessary 
stores. 

Every housekeeper must be supposetl capable of en- 
tertaining his acquaintances; but I feel full confidence 
in saying, it would be vastly better if spirituous drink 
was used with a more sparing hand, on these occasions. 
To the parturient women they are seldom necessary, or 
even safe. Such women are always more or less fever- 
ish, particularly till after the breasts are filled with milk. 
Although the weakness, under which they labour, is of 
a direct kind, still, such is the irritability and disposition 
to fever, that cordials can seldom be used. So soon as 
the milk fever is over, a diet reasonably nutritious will 
generally be allowable; but spirits, or cordial drinks, im- 
part no sustenance, and will, in all cases, excite more or 
less fever. 

Much errour is practised in keeping such women too 
warm: their apartments should never be warmer than. 
they are accustomed to when well, and when feverish, 
their rooms ought to be cooler. Besides this practice 
of heating rooms too much, women in the country ge- 
nerally have too much clothing on: it is not uncommon 
for them to get to bed with as much clothes on as they 
usually wear; the injury arising from this source is im- 
mense, and therefore every effort ought to be made to 
banish it. 

It would be well if those things were kept more pri- 
vate; as things now stand, every woman of slight ac- 
quaintance, expects to be invited to the feast, and much 
fatigue to the patient is often the consequence; besides, 
the visiters never come without news, and often of such 
a character as to do serious injury to the patient. It 
would be a good rule if none but a particular friend or 
two were admitted to the room of the patient, until she 
is able to sit up without fatigue. 

Diseases of parturient women generally proceed from 
mismanagement; and as the system is always considera- 
bly reduced, it is always necessary to use the utmost ex- 
pedition in getting good advice, as soon as any thing 



OF INFLAMMATION OF THE UTERUS. 455 

amiss is discovered; and as men of medical skill are 
now to be found in every part of our country, the only 
advice absolutely necessary here, is to admonish them to 
beware of quacks, whether men or women, and conform 
strictly to the advice of those known to be competent. 



OF DISEASES OF THE FEMALE. 



SECTION I. 

Of Inflammation of the Uterus. 

» 
THE reader, by turning to the observations on inflam- 
mation of the other viscera, and especially to my general 
observations on visceral inflammation, will be prepared 
to prescribe in cases of inflammation of the womb. This 
disease is sometimes met with in all the different condi- 
tions of woman. 

It is known by pain in the lower part of the belly; ex- 
treme soreness is felt from feeling over the region of the 
uterus; there are considerable chills and flashes of heat; 
distress of countenance; a hard weak pulse; vomiting; 
frequent inclination to go to stool; obstruction of urine; 
and, in severe cases, delirium; and sometimes a discharge 
of acrid fluids from the uterus. 

This inflammation is to be removed by bleeding, cool- 
ing mild purges, as rochelle salts, or epsom salts, or 
phosphat of soda, or best cold-drawn castor oil, emol- 
lient glysters; cooling mixtures of nitre, cremor tartar, 
&c: always remembering, that we must regulate the 
strength and repetition of these remedies according to 
the strength of constitution, &c. The lowest possible 
diet, and cooling drinks, are indispensably necessary du- 
ring active inflammation of the womb. And this treat- 



45fi OF THE PROLAPSUS UTERI, &C. 

ment applies to the parturient woman equally well as in 
other conditions of life. 



section n. 
Of the Prolapsus Uteri, or falling down of the Womb, 

This disagreeable complaint is often the consequence 
of too severe labour of females, such as too much stand- 
ing, lifting, &c. It may also arise from whatever relaxes 
the body. There is, perhaps, no more common cause 
of this disorder than too early exertion after lying-in. It 
is not uncommon, where this disease is suffered to run 
on, for the uterus to be protruded without the labia. In 
relaxed habits especial care is to be paid to the general 
system, and every useful means for invigorating the body 
is to be pursued; much stooping, or straining, is care- 
fully to be avoided, but reasonable exercise is never to 
be omitted. Costiveness is to be carefully avoided; this 
indeed, is sometimes the cause of the prolapsus. The 
bowels should be kept regular; the habits in general, must 
be temperate; mild astringent injections should be fre- 
quently used, of weak solutions of sugar lead in water, 
infusions of bark, or oak bark with a little alum; but if 
any considerable inflammation and pain are present, these 
articled must not be used: the patient should be bled, use 
emollient glysters, and foment the prolapsed part fre- 
quently with ware* milk and water. 

As soon as these symptoms of inflammation and pain 
are removed, by the above means, together with rest, 
the patient should resume the astringent washes, and 
other means for strengthening the parts affected, as well 
as the whole system. 

Should all those things prove ineffectual, by applying 
to men of judgment, an instrument called a pessary may 
be had, which will render the patient more comfortable^ 
by keeping up the parts. 



OF THE CHLOROSIS, OR GREEN SICKNESS. 457 



SECTION III. 

Of the Chlorosis, or Green Sickness. 

This disease affects, principally, young women, and 
the unmarried are most subject to it. It is known by 
a bad colour, a dead-like whiteness in tfie face and other 
parts; great lassitude and heaviness; swelling of the 
face and ankles; tension, and weariness of the feet and 
legs; difficult respiration, or rather a panting after exer- 
cise; palpitation of the heart; pain in the head; fever- 
ishness; drowsiness; an unusual appetite for some kind 
of trash, as clay, chalk, coals, salt, sugar, &c. and gene- 
rally a suppression of the menses. When the case is in- 
veterate, yellowish or dark greenish splotches, which 
have the appearance of bruises, are found on the legs 
ill particular; and with hemorrhages from the nose, 
and tender gums, give the disease some resemblance to 
scurvy. 

The following treatment will generally succeed. Give 
a purge, and the following is probably best — rhubarb 
and jalap, each ten grains, calomel and aloes, each five 
grains, make eight pills, give Ave of these, and if they 
do not operate pretty well, give the remainder in four or 
six hours. The next day, give one scruple of ipecacu- 
anha, and whether it operates or not, drink freely of weak 
sage or ground ivy tea; always, however, leaving the me- 
dicine about an hour on the stomach if it does not vomit, 
before you begin to drink. The next day put two grains 
of tartar emetick into a pint of water, take one or two 
spoonfuls of this, as the stomach will bear, in the morn- 
ing and evening: this should be used five or six days. 
During all the above time the patient should take a mild 
anodyne every night; for this purpose take opium four 
grains, ipecacuanha six grains, make eight pills, and 
take one of these each night. 

After using the above live or six days, commence with 

the following, and continue it until the strength, &c. is 

well restored. Take iron filings and assafoetida each 

one dram, flour or crumb of bread enough to make the 

58 



458 ©F THE FLUOR ALBUS. 

mass tough enough for pills; make sixty-four: two to be 
taken morning and evening, drinking after each half a 
wine glass of bitters of gentian, columbo, orange peel, &c. 
steeped in water and a little spirit of some kind, to pre- 
vent its souring: about a gill of spirits, or good old whis- 
key to a quart of water, will answer this purpose; about a 
dram of salt tartar or soda, may be added to a quart: 
this should always be strained after standing two or 
three days. The patient must carefully avoid all unna- 
tural food, and live on a light nourishing diet. Cold wa- 
ter will be the best drink: spirits, much spices, orgrea- 
sv food, must be avoided, as well as too much sour arti- 
cles, as pickles, vinegar, &c. Exercise must never be 
omitted in this disease. 

SECTION IV. 

Of the Fluor Mbus. 

A simple fluor albus unaccompanied with some seri- 
ous affection of the uterus, is known by these symptoms, 
a discharge from the vagina of a whitish or yellowish 
mucous, sometimes becoming greenish, and having an 
ill smell; this, however, is often the consequence of ne- 
glect, or want of cleanliness. These symptoms are ac- 
companied with paleness of the face, severe pains in the 
back, loss of appetite, swelling of the legs and eyelids. 
For this disease, precisely the same treatment as recom- 
mended in the preceding article will answer, but should 
be aided by injections of milk and water, often repeat- 
ed; and if these do not succeed, a little sugar lead may 
be added to water, and used in the same way; but these 
injections into the vagina should be very weak, half a 
dram of sugar lead to a pint of water will be a proper 
strength, and it should be used tepid. Where the symp- 
toms have run high from want of frequent washing of 
the part affected, or other causes, bleeding once or more 
will be necessary, with the constant use of the milk and 
water injections into the vagina, and at the same time 
gly^ters, of the emollient kind, must be used frequently; 
sitting over a warm bath will also be advisable in severe 



OF THE DISEASES OP CHILDREN. 459 

cases. As soon as the symptoms abate, the iron pills, 
&c. recommended for chlorosis, should be used with ex- 
ercise accommodated to the patient's strength: the cold 
bath may also be used to advantage. Much stooping, 
or working over the fire will not suit such women. 

Gross or fat women are often troubled with a milder 
kind of this disease, which requires nothing but exer- 
cise, and great attention to cleanliness; for it is often 
in some measure constitutional, and cannot be removed. 
The warm balsams, as copaiba, &c. have been found 
useful in debilitated habits. Tincture cantharides is 
also a valuable medicine; twenty or thirty drops may 
be given twice a day: if strangury come on, omit the 
medicine till this symptom wears off, and then begin 



OF THE DISEASES OF CHILDREN. 

SECTION I. 

Introductory Remarks. 

IT is in works on the diseases of women and children 
only, that full directions can be expected for those dis- 
eases. I shall therefore but very briefly, point out a 
few cautions, for the management of new born infants, 
and beg leave to refer the reader to works on the com- 
plaints of women and children. 

1. The newborn infant should never be washed with 
spirits, nothing but warm water should be applied, nor 
is it material whether all the scurf comes off at the first 
washing. It is vastly better to leave a considerable 
portion of it, than to fret the very tender skin by the 
harsh rubbing, which is often practised. 

2. Much injury is done infants by giving them harsh 
articles, with a view of carrying off the meconium; tilings 



460 OF THE DISEASES OF C&1LDIIEN. 

the most discordant are crammed down their throats, as 
soon as they fall into the hands of ignorant mid wives. 
It is very seldom any thing is necessary for this pur- 
pose, the child should be put to its mother's breast as 
soon as practicable, and this will generally answer eve- 
ry purpose. If the meconium is tardy in coming away, 
mix equal parts of sweet milk and boiling water, sweeten 
this well with sugar, and give a few tea spoonfuls eve- 
ry now and then, and if this does not succeed, a lit- 
tle warm water should be given as a glyster. Never 
give purgatives or other doubtful articles, without good 
advice. 

3. Much injury is done children by keeping them too 
warm, and also by exposing them to too much light; 
sore eyes, fevers, &c. are usual consequences of mis- 
management in those things. 

4. It should be made an invariable rule to wash chil- 
dren once every day, all over; the water should be te- 
pid at first, but in a few days it ought to be eold: this 
will not only tend to invigorate the body, but is indis- 
pensably necessary for the purpose of keeping the skin 
sound; and it is also necessary that their clothes be 
changed every day, at least their cap and linen, and 
their clean cloths should be frequently changed; this is 
not only necessary as a means for preventing what is 
called scalding, &c. but the practice of suffering chil- 
dren to remain wet disposes them to rickets and other 
diseases. 

p. Children who have the breast of the mother, or of 
a healthy nurse whose milk is fresh, that is, one that 
lay-in about the time of the mother, should not be fed; 
the milk of a healthy woman is quite sufficient, and the 
only article which is really suited to the stomach of ten- 
der infancy. 

6. Where the breast is not to be had from accidental 
circumstances, milk with a little sugar should be their 
only diet for the first few days, or even weeks; after- 
wards, a little flour may be boiled in their milk. The 
milk ought to be reduced a little, for some time, by mix- 
ing k with water; for the human milk, which suits them 
best, contains less cheese and butter, but more sugary 



OF COMMON GRIPING OF CHILDREN. 46i 

matter than cow's milk; so that, by adding water, we 
lessen the quantity of cheese and butter, which are too 
heavy for the infantile stomach, and by adding sugar, 
in reasonable quantity, we have a mixture strongly re- 
sembling human milk. 

Vast injury is done infants by overfeeding them, and 
more especially by giving articles too gross for their di- 
gestive powers. 

SECTION II. 

Of common Griping of Children. 

Children are much disposed to gripings, but doubt- 
less in a majority of cases, this affliction proceeds from 
mismanagement, overfeeding, keeping them too warm, 
or suffering them to remain wet, are the most usual 
causes of gripings; the first by suffering a kind of fer- 
mentation to take place in the stomach, from the ina- 
bility of the stomach to digest, more than a certain quan- 
tity of wholesome food, and from an inability to digest 
gross articles at all, fills the bowels and stomach with 
sharp wind. The two latter, that is keeping them too 
warm, or suffering them to remain wet, by relaxing the 
general system, destroys the tone of the stomach. 

Where due attention is paid to the management of 
children, in regimenous matters, they will seldom re- 
quire medicine, for the removal of gripings. 

But no degree of prudence, or skill, can prevent this 
complaint from troubling some children; even here, we 
are not rashly to fly to medicine. The following will 
often succeed: take pure water two ounces, oil of mint, 
or fennel, or anise one drop, soda ten grains; of this, 
one or more tea spoonfuls may be given whenever the 
pains are severe. If this does not succeed, give a little 
rhubarb and magnesia, or an emollient glyster. 

In extreme cases, a little Godfrey's cordial, or a few 
drops of equal parts of spirits nitre, and laudanum, may 
be given; but opiates are to be given sparingly, and it 
will generally, be better to suffer them to cry reasona- 
bly, than to give opium to lull them to rest; this is too 



462 OF THE YELLOW GUM. 

often done solely with a view of getting rid of their 
noise: such conduct is highly reprehensible. To con- 
clude, I have no doubt but a free use of opiates, or cor- 
dials, generally, not only very materially impairs the 
strength, and disposes to scrofula, foulness of the skin, 
&c: but, that it really often materially impairs the fa- 
culties of the mind. I think I have seen one well 
marked case of deplorable epilepsy, from the abuse of 
opium and cordials. 

Let it be a matter of conscience, to use the proper at- 
tention to dress, exercise, food, &c. of your child, and 
if obstinate griping troubles it, get good advice. 

SECTION III. 

Of the Yellow Gum. 

This disorder is characterized by a yellowness of 
the skin, and of the white of the eyes. European au- 
thors speak of it, as being frequently a dangerous 
disease. 

I am inclined to believe, it is neither common nor dan- 
gerous, in the United States. But I have seen many 
cases of it in one neighbourhood: in Somerset county, 
Pennsylvania, this disease is very common, but I have 
never seen it attended with danger. It has been sup- 
posed that this yellowness of the skin is owing to me- 
chanical obstruction of the biliary ducts, but these no- 
tions are probably ill founded; it is much more likely, 
that the liver either secretes the bile in undue quantity, 
or of a vitiated quality; or what I think still more 
probable, this affection of the skin is owing to inflam- 
mation of the skin or liver; for in all the cases of yel- 
low gum which I have seen, the discoloration occurred 
a few days after birth, and always followed tedious 
labours. 

We should never give medicine for this disorder, un- 
less the child be really sick, when it will mostly an- 
swer every purpose to open the bowels with castor oil, 
if it can be had very nice, if not, rhubarb and magnesia 
will answer; and a gentle emetick of ipecacuanha should 



OF INFLAMMATION, OR SORENESS OF THE EYES. 463 

be given: these remedies with the daily use of the te- 
pid bath, will generally answer; but if the symptoms of 
fever, pain, or distress of any kind continue, the best 
advice should be obtained, for authors of much respec- 
tability tell us this disease is sometimes dangerous. 

SECTION IV. 

Of the Red Gum. 

The red gum is a disease which affects the skin of 
infants, and resembles measles much in its appearance. 
The eruption appears in little red pimples, which rise 
up so as to be felt, and these prominences sometimes 
appear yellowish; but, in some cases the eruption is 
confined to particular parts of the body. It is seldom 
attended with much fever, or distress, unless augmented 
by mismanagement. 

There is no doubt with me, but this affection is al- 
most universally the consequence of surfeits from feed- 
ing children too much; from wet; or from keeping in- 
fants too warm, or not changing their clothes as often as 
is necessary. 

A faithful use of the tepid, or cold bath, according to 
the manner in which the child has been managed, will 
seldom fail to remove this disease of the skin; if fever 
comes on, the bowels ought to be opened with the mild- 
est purgatives, or glysters. But children thus affected, 
are liable to other diseases, so that in all cases where 
any considerable indisposition occurs, get advice, for 
in all cases, much is gained by early application to the 
skilful. 

SECTION V. 

Of Inflammation, or Soreness of the Eyes. 

This is mostly owing to exposing infants too much to 
the light; we should carefully shade the eyes of young 
infants from the light; but let us not, in doing this, de- 
prive them of free exposure to air, as is often practised. 



464 OF THE AFHTHJE,' OR THRUSH. 

Let their rooms be well aired; but never suffer a strong 
light to shiue into their eyes, for the first two or three 
weeks. 

Never be induced by any authority, however respec- 
table, to apply washes of sugar lead, and such like, to 
the eyes of infants. Bathe them very frequently with 
warm milk and water; and if the case is obstinate, blind- 
fold the eyes, by applying very clean rags wet with milk 
and water; and apply a small blister to the back of the 
neck; give a little cooling physick, and let the nurse be 
a little abstemious for a few days. 

If they do not mend, under this treatment, apply cold 
spring water, or nice rose water. If this inflammation 
occurs in children a little advanced in life, we should 
pay a scrupulous attention to the nonnaturals: for where 
this affection of the eyes arises from a relaxed habit, 
which is sometimes the case, no local applications can 
avail; our only hope is in invigorating the general sys- 
tem, by all the usual means for that purpose, among 
which, exercise in the open air, holds an important 
share. 

SECTION V!. 

Of the Aphtha? , or Thrush. 

The thrush is a common disease in nurseries, where 
children are overfed, but whatever tends to relax the ge- 
neral system will tend to produce this affection; for it is 
probably always accompanied with, if not actually caus- 
ed by, indigestion. 

It is known by the appearance of little whitish, or 
whey-coloured blisters, on the lips, in the mouth, throat, 
&c; and it is excessively painful, and will bleed from 
the act of sucking, or from attempts at washing the 
mouth. It is often attended with fever and other dis- 
tressing symptoms, as nausea, &c. 

In bad habits, where a too cordial diet, and a too warm 
regimen, has brought on the disease, these blisters some- 
times terminate in mortification. 



OF CONVULSIONS OF CHILDREN. 465 

No rude attempts at washing the mouth with rags, 
&c. should ever be made; for, by the violence used, you 
increase the inflammation, and thus add to the foulness 
of the mouth, and aggravate the disease. 

It will generally be sufficient, in these cases, to give 
an erne tick of ipecacuanha or white vitriol; then open the 
bowels with rhubarb, or its syrup. At the same time, 
let the following mixture be put frequently into the 
mouth, in portions of one or more tea spoonfuls every 
now and then. Take soda one scruple, water two ounces, 
dissolve the soda in the water, and then add two tea 
spoonfuls of honey: mix the whole well together. 

These cases are, however, sometimes extremely dan- 
gerous, partaking of the character of angina maligna, or 
ulcerous sore throat; so that, in all cases attended with 
serious indisposition, the best advice should be obtained. 

SECTION VII. 

Of Convulsions of Children. 

From some peculiarity in the constitution of children, 
they are subject to convulsions from a variety of causes; 
among these may be enumerated irritation of the sto- 
mach or bowels, from indigestion; injuries of the head, 
or other parts; even cuts, burns, injuries from pins, &c; 
the sudden revulsion of eruptive disorders, particularly 
where that sinking in of the eruption is occasioned by 
too warm a regimen. 

Smallpox, measles, and other fevers, lead to convul- 
sions; so does teething, violent frights, &c. From this 
variety of causes of convulsions, it must be evident much 
judgment is necessary to enable us to distinguish or dis- 
cover the cause, and adapt a suitable treatment; more 
especially when we recollect that convulsions are always 
dangerous; death, crippling, or epilepsy, are often the 
consequences of convulsions: with what care, then, 
should we endeavour to avert these dreadful conse- 
quences by getting good advice! 

In all cases of sudden convulsions, the child should be 
stripped and examined whether no wound exists, fov 
59 



&$& OF THE CHOLERA INFANTUM, &C. 

even the pricking of a pin may be the cause. If the ha- 
bit is good, we should bleed pretty freely, and if the 
cause is unknown, or if there is any suspicions of poison, 
as James Town weed, spirits, &c. an emetick of white 
vitriol, or ipecacuanha, should be given. 

Should the convulsions still continue, or, in reduced 
habits, at first, give stimulant glysters till the bowels are 
freely opened, then put the patient into the warm bath; 
but while those things are transacting, get a practitioner 
of judgment, as much skill is often necessary on these 
occasions. 

SECTION VIII. 

i 
Of the Cholera Infantum, or Summer Disease. 

This disease of children is principally found in cities, 
and it is said, by Dr. Rush, to affect infants principally 
from the first or second week, till the end of the second 
year of their age. And, according to Rush, it occurs in 
Philadelphia about the first of June, but something ear- 
lier in the Southern states. 

Its most severe symptoms are violent sickness, and 
vomiting; purging; high fever. The discharges by stool 
and vomiting, are mostly, a yellowish green, but liente- 
rick symptoms often attend, as slimy stools, and the 
passing the food undigested, or they are quite watery, &c. 
The patient is extremely restless, tossing and drawing up 
the feet, and throwing back the head; the pulse is gene- 
rally soon found very weak; and the fever which attends 
is remittent in its character, and is mostly highest in the 
evenings; delirium, and even mania are sometimes pre- 
sent. The belly is generally swoln, the countenance lan- 
guid, and distressed; the eyes are open during sleep. 
There is great thirst; considerable emaciation takes place; 
the stools are mostly extremely fetid. 

Many more distressing symptoms sometimes attend 
this distressing and mortal complaint. 

A first consideration, in these cases, is to get the pa- 
tient into the country; and if circumstances do not ad- 
mit of their removal, they should be carried out daily du- 



OF THE CHOLERA INFANTUM, &C. 467 

ring good weather, once or oftener. In all cases, as soon 
as any serious vomiting occurs during the season of this 
disease, a gentle emetick of ipecacuanha should be gi- 
ven, the bowels should be opened with glysters, contain- 
ing a very little rochelle salts; and as soon as the bowels 
are opened, or rather as soon as the injection has come 
away, give mild anodynes, and the following formula will 
generally answer a good purpose: Take soda half a 
dram, water two ounces, oil cinnamon, or mint, two 
drops, dissolve the soda in the water, and give from half 
a tea spoonful, to three or four, according to the age of 
the patient; and with the first dose, and every two or 
three hours afterwards if necessary, give a common small 
dose of laudanum. 

Soda water highly impregnated with fixed air, should 
he given, nice toast and water, or linseed tea, or slippery 
elm water, will be suitable drinks, in the early state of 
the disease. When the case is somewhat advanced, 
dewberry tea, or chamomile in cold infusion, or best wine 
and water, may be given. 

The diet ought in general to be light and nutritious, 
as well toasted bread with milk, sago, animal jellies, a 
little ripe fruit, small quantities of rich broth, or where 
the stomach will not retain these articles, glysters should 
be given, of weak mutton, or other light broth, three or 
four times every twenty-four hours. 

This disease sometimes terminates in recovery or death 
in two or three days, in other cases it continues off and 
on, for as many weeks and even months. 

I suspect the most usual cause of this disease is over- 
eating, and this may be the case where very little is eat- 
en, owing to the relaxed state of the stomach, and the 
general system, from the debilitating tendency of the 
warm season. This debility or languor of the stomach, 
and general system, may often be prevented, by taking 
weakly children, frequently into the country; by the mo- 
derate use of good old wine, and of a little salt meat, 
or salted fish; by avoiding much trashy vegetables, or 
much sweetmeats. A reasonable use of ripe fruit is al- 
ways necessary, but is easily carried to excess with de- 
licate children. 



468 OF THE CHOLERA INFANTUM, &C, 

This disease is usually very mortal in cities; and 
calls for much skill when protracted, for a more deplora- 
ble case can hardly be met with than the last stage of this 
disease, where it has continued long; the body becomes 
so emaciated as to cause the bones to cut the skin, hick- 
cup, convulsions, sore mouth, &c. render the case some- 
times truly distressing. 

Although the cholera infantum is most common, and 
most dangerous in our cities, cases of it are to be met 
with every season, in country practice. It. is known in 
many places by the name of "summer purging;" I have 
generally succeeded in these cases by giving a gentle 
emetick, opening the bowels with mild purges, as senna 
and manna with a little cremor tartar; and after these 
evacuations, a mixture of soda and water, with some es- 
sential oil, and occasional doses of laudanum and sweet 
spirits of nitre. But in a majority of cases, a single 
dose of the senna, &c. and afterwards the soda mixture 
would check the complaint. In inveterate cases where 
the patient was reduced, a mixture of magnesia, oil anise, 
sugar and water, would generally answer. 

The same diet and drinks should be used as above 
mentioned. Let it be carefully remembered in all vio- 
lent cases of cholera infantum, that evacuations are never 
necessary, except they are used before the debility is con- 
siderable; on the contrary, they would be attended with 
the utmost hazard, and therefore where there are doubts, 
a physician should be consulted. If none is to be had 
in reasonable time, we may give jthe soda mixture with 
laudanum, not only without risk, but with considerable 
prospect of success. It has been supposed the teething 
of children renders this disease more severe, but we de- 
rive little advantage from a knowledge of this fact. I have 
given as my opinion, that the health of the teeth depends 
especially on the general health, so that it would seem to 
follow, that we can only aid the infant in cutting its teeth 
by proper attention to the usual means, for invigorating 
the general system. 

It may be remembered, that by the careful manage- 
ment of those means, we not only promote more easy 



OF THE VACCINA, OR COWPOX. 469 

teething, but the same means are the most certain pre- 
ventives from cholera infantum. 

Children in general, are kept too much confined in 
warm rooms, they are rendered delicate by too much 
nursing, by which they are kept from using their own 
limbs; they are indulged in too much sweetmeats; they 
use too little milk, too much coffee, and fresh meat, and 
cheese; they should never pass a clay in the warm sea- 
son without a little salted meat, or fish; but these articles 
must be used sparingly, or by exciting thirst they will do 
much mischief, for nothing is worse than oppressing the 
stomach with too much watery liquids. Lastly, in all 
cases of cholera infantum, I would advise the exhibition 
of a glyster or two, of tepid or cool water and starch; 
and if this simple remedy is used as soon as any symp- 
toms of this disease appears, it will often check it in its 
forming state; and this same remedy ought always, to be 
used in cases where a child passes twenty-four hours 
without a stool, in the warm weather. 

SECTION IX. 

Of the Vaccina, or Cowfox. 

A period of nearly twenty years has now elapsed since 
the illustrious Jenner, discovered the prophy lac tick pow- 
ers of this disease. And like a noble philosopher and 
christian, he made every endeavour to convey this migh- 
ty blessing, not only to his nation, but to a world; the 
savage, the heathen, in short, mankind was the family 
to which Jenner ardently wished to bestow this heaven- 
ly JEgis. 

How wondrous strange that parents, guardians, &c. 
should still foolishly or wickedly neglect to secure those 
under their care, from the dreadful horrours, and suffer- 
ings of smallpox. The countenance of the christian and 
of the savage, through every land, has been made to 
smile and to acknowledge the goodness of the giver, and 
still shameless wretches are found, who regardless of eve- 
ry obligation which they owe their children and society; 
and regardless of the certainty of the preventive powers 



470 OF THE VACCINA, OR COWPOX. 

of this mild disease, known to be so. by long experience, 
suffer their children to run every hazard, for the paltry 
consideration of saving a few shillings. 

Many people formerly made a pretence of pious sub- 
mission to the will of heaven, in suffering their children 
to take the. smallpox naturally, because some little risk 
attended the inoculation, for that disease, but as there is 
no possible danger attends the vaccina, there is not the 
shadow of an excuse. 

We have a strong manifestation here of the proneness 
or liability of mankind to run into excess; and a little 
reflection will convince us that this is one of the princi- 
pal sources of our troubles and wrongs to each \ other. 
No sooner had the humane discoverer, of this preven- 
tive, and after him, humane physicians in every country, 
used all their eloquence and persuasion, to procure con- 
viction, and the adoption of this preventive, than they 
were assailed by opposition the most intemperate; this 
led to a necessity for making this preventive cheap, and 
easily accessible to the poor, and the consequence of this 
was, that the people soon view this as really worth little 
or nothing. 

And many considering even a dollar or two too much, 
undertook to vaccinate their own people: but I beg leave 
to tell all such that this is extreme meanness. 

What, though I have several children, or a score of 
slaves, who have not had this disease, can I with any 
kind of propriety, go to the patient of the physician, 
and actually infringe on his rights? shame could cloud 
the face of every man who would act thus meanly, where 
a physician is to be had. This preventive is wanted 
but once during life, and the expense is a trifle; besides, 
it cannot with any appearance of truth, or probability, 
be maintained that there is not a considerable decree of 
judgment, founded on experience, necessary to enable us 
to decide with any certainty, in doubtful cases, which 
are ever liable to occur from the most trifling accidental 
causes. 

Was it not a physician to whom this blessing was re- 
vealed? was it not the physicians who brought it here, 
and maintain it among you, by preserving the infection; 



OF THE VACCINA, OR COWPOX. 4#I 

and has it ever been a source of profit to them. It is 
true, a few practitioners made a little when there was a 
vast number of patients, but compared with the benefit 
which they distributed, the amount was nothing. But, 
as things now stand, no physician in the country can pos- 
sibly vaccinate for a dollar or two, without actual loss of 
time; and even in town, the value of the things is so vast- 
ly great, and so decidedly belongs to medical men, that 
the usual fees ought at least to be doubled. 

Notwithstanding I am so decidedly of opinion, that 
this disease should be left to the physician, I am still 
clearly of opinion, that every person should make it their 
business to be well acquainted with its character, for the 
following reasons. 

1. Persons in the country may have to do with stran- 
gers; who under pretence of being physicians, may im- 
pose on the publick, and deceive the unfortunate patient. 

&. Men of ample experience are sometimes remiss in 
their attention, and woful consequences sometimes arise 
from their neglect. 

3. This disease can only be known by its outward ap- 
pearance; and if the pock is accidentally injured by 
scratching, &c. the physician of skill, and with every at- 
tention may be perplexed and put to much trouble: thus 
on the morning of the eighth day, a beautiful pock exists 
on the arm, a few minutes before the practitioner arrives 
it is torn off, how is he to decide? 

In all these cases, a proper knowledge of the appear- 
ance of the disease, by those who nurse, will enable 
themselves and the vaccinator, with much greater cer- 
tainty to decide, and if imposition is attempted to be 
practised by strangers, it may often be detected. 

This pock has these appearances: on the third day the 
part where the infection was inserted, resembles a flea- 
bite; by the sixth, it resembles a pretty little pearl, being 
pearl coloured, and perfectly circular in its circumference, 
boldly elevated at its edge, and filled with a limpid fluid, 
and depressed in the middle, where there is a little dark 
spot. If two punctures were made by the lancet, or if 
an incision was made, the pock will be oval, but the dint 
in the middle, and prominent edge are always present. 



47& OF THE VACCINA, OR COWPOX. 

By the eighth day, the pock is considerably larger, is 
more elevated, and the part a little swoln, and slightly 
red, and there is considerable hardness extending pretty 
deep into the arm. On the tenth, there is a little brown- 
ish yellow circle, which looks speckled, and is called 
areola; and from this on the same day, is spread a beau- 
tiful red colour of the skin, for a considerable distance 
around, called the efflorescence. By the twelfth day this 
has nearly disappeared, and the pock being pretty much 
dried, looks yellowish, but there never is any yellow 
pus through the whole disease. The scab soon becomes 
brown, or mahogany coloured, and by the eighteenth, 
it may often be removed. 

About the fourth day a slight feverishness is felt, and 
a more considerable one in a few cases, particularly in 
adults, about the seventh, eighth, or ninth day; about 
this tune there is considerable swelling and soreness un- 
der the arm. 

Persons who will make it their business to examine 
carefully a few cases of cow pox, cannot easily be at a 
loss to distinguish it afterwards; and it is most clearly 
the duty of every person to have such knowledge. I 
have, more than once, visited children on the eighth day, 
and neither father nor mother could tell even whether 
the operation had succeeded, and where the pock had 
been rubbed; this was sometimes a source of much 
trouble and anxiety. 

No child should be suffered to pass the second or third 
month without being vaccinated. 

It may be necessary to observe, that there is consider- 
able variety in the progress of the pock, in a few cases, 
some running their course more slowly, and some more 
rapidly, than according to the course above pointed out. 
There are also some cases where little or none of the are- 
ola or efflorescence is present; and in the coloured skin 
we cannot perceive it. But the elevated edge, the dint 
in the middle, the limpidness of the fluid within, and the 
brownness and regularity of the scab, are always present, 
and sufficiently distinguish this from every other eruption. 
A single pock is sufficient. 



OF MILK BLOTCHES, OR CRUSTA LACTEA. 4^3 



SECTION X. 

Of Milk Blotches, or Crusta Lactea. 

Eruptions of this kind occur in gross children, and 
seem to proceed from some defect in the milk of the 
nurse. I think it is highly probable overfeeding has a 
considerable share in its production in many cases. 

This disease is not dangerous nor is it apt to pene- 
trate so far as to occasion marks, generally speaking; 
but it is sometimes excessively troublesome, and if ne- 
glected, or improperly treated, may become dangerous, 
and liable to leave unpleasant marks. 

It is known by a whitish or dusky eruption in large 
scabs, affecting the forehead, head and. face, but also 
found sometimes over the body. This affection, like 
many others, has been viewed, by some physicians, as 
salutary: but this is an unfortunate errour for the poor 
little sufferers. 

Like disease in every other form, it is an enemy, and 
ought to be removed as far as in our power. I am con- 
strained to observe, that it is probable that these old no- 
tions of the salutary nature of many diseases arose, in the 
first instance, from motives really base. Thus, in the 
infancy of medical science, when physicians and patients 
were ever looking for specificks, the former were likely 
to be brought under the imputation of being ignorant or 
unskilful, because many diseases, in spite of all their ef- 
forts, continued for weeks, and even months. 

This was vexatious to the patient, and humbling to 
the doctor; and as it was much easier to propagate false 
notions than to cure their patients, nothing could so ad- 
mirably answer their purpose as to persuade the patient 
that his disease was salutary. The credulous patient 
would groan, sweat, and might die, hugging up this 
phantom, and the doctor, who was, perhaps, more igno- 
rant than the patient, got much credit for his wonderful 
knowledge in finding diseases he could not cure, were 
salutary, and therefore patiently to be borne. 
60 



474 OF TEETHING, OK CUTTING TEETH. 

The motive was, I have no doubt, originally a base 
one; but the publick having no means of refuting it, and 
the majority of the faculty falling in wit^ it without re- 
flecting for themselves, the first motive was soon lost 
sight of, more especially as men were soon found who 
undertook to defend these notions by reasonings; and 
such were the times, that, however sophistical, any thing 
in the form of reasoning was held almost as sacred. I 
have in my library a book printed in the year 155S, 
called the »*Boke of Secretes," which is marvellously 
marvellous. 

I hope I shall be pardoned for this digression; for I 
think this the most destructive of all errours, in the prac- 
tice of medicine, in the present day: and this is the last 
opportunity I shall have, in this work, to speak of it. I 
now return to my subject. 

The cure for crusta lactea is, in good measure, to be 
looked for from a change of the nurse, when perfectly 
convenient, when not, the parent or nurse should live, as 
much as her health will admit of, on a vegetable and 
milk diet. But the infant, if it has been fed, should be 
stinted in some measure in its food, or the food should 
be rendered thinner and lighter; and animal food should 
be wholly withheld for some time, unless it be a very 
little salted meat, during the warm season. 

The bowels should be kept reasonably laxative, by 
the use of cremor tartar and sulphur, or magnesia and 
rhubarb. The tepid, or cold hath, should be used dai- 
ly; and occasional washing with the mildest castile soap 
will be useful; but other washes, or drying applications, 
should never be used without advice. 



SECTION XI. 

Of Teething, or Cutting Teeth. 

There has been much diversity of opinion respecting 
the process of teething. Some practitioners and nurses 
attributed almost all the diseases of children to the irri- 
tation, &c. arising from the cutting of the teeth; while 
another set argue, because it is a natural process it can- 



OF TEETHING, OR CUTTING TEETH. QJ5 

not reasonably be supposed to be attended with pain, or 
disturbance to the animal economy. Both these extremes 
are probably wrong; and the truth most likely is, that 
children, nearly in a state of nature, are not much affect- 
ed by the coming of the teeth; but in civilized life, 
where our infants so evidently come into the world with 
an infirm constitution, how can we reasonably suppose 
they will not be affected with pain and other conse- 
quences from this piercing of the gums by the teeth? 

Children somewhat advanced in life, are subject to 
considerable pain in cutting their teeth. But after much 
reflection and considerable experience, I am clearly of 
opinion the majority of the publick attribute much more 
to the teething of their children than is consistent with 
truth. I believe that most cases of diseased bowels and 
of convulsions, &c. which are attributed to the teeth, are 
occasioned by overfeeding, which produces colicky af- 
fections of the stomach and bowels. 

Upon the whole, I think it is pretty evident the pro- 
cess of cutting teeth depends on the general health, and 
therefore it is only by strict attention to the nonnaturals, 
&c. that we can aid them through this necessary process. 
And I would advise parents not to indulge their infants 
with hard substances to bite upon; nothing but a crust 
of bread ought to be used for this purpose; for even oris 
root, wax caudles, elastick gum, &c. will, by constant 
use, harden the gums quite as much as harder sub- 
stances. 

About the fourth month, often later, two teeth appear 
in the lower jaw, in front; and pretty soon thereafter, 
two more appear in the upper jaw, the others gradually 
succeed; so that, by the end of the second year, chil- 
dren have often ten teeth in either jaw. 

In cutting these, some children suffer considerably; 
but little can be done, except endeavouring to invigo- 
rate the constitution. Cutting of the gums is seldom 
necessary; if they are cut early, the incision will heal, 
and render the gums more callous; if we delay it till the 
teeth are nearly through, the worst is mostly over, and 
the cutting with an instrument is unnecessary. The 
gums should never be cut without good advice. 



476 OF TEETHING, OK CUTTING TEETH. 

Lastly. If a child is sick, we must be governed by 
the symptoms present, whether they are cutting teeth or 
not. I am well convinced children are often injured by 
inattention to this rule; thus, if a child is supposed to be 
affected with worms, or troubled by its teeth, the whole 
attention is directed to this supposed cause; and, per- 
haps, in a majority of cases, the disease is from a cause 
wholly different; so that, in our prescriptions, we are to 
be governed by symptoms, and prescribe for those pre- 
sent, while we, at the same time, carefully endeavour to 
find out the cause; but alas! how often is this hidden, 
and even mistaken! 



DISPENSATORY, OR MATERIA MEDICA. 

SECTION I. 

List of Medicines. 

IN this list all articles will be found, which are to be 
kept as permanent medicines, and the properties of each 
is pointed out. The reader will also observe, that every 
word printed in italicks, either shows that the receipt for 
preparing the article, will be found under the word so 
marked, or that something important will be found un- 
der that head. 

Aloes — purgative — laxative — emmenagogue. 

Alum — antihemorrhagick — restringent. 

Ammoniacum — stimulant expectorant. 

Arsenick — tonick, in form of Fowler's solution — caustick. 

Assafcetida — diffusible stimulant, in form of tincture— 

antispasmodick in form of tincture, glyster, and in 

substance. 
Armenian Bole (or Red Role) — external astringent, in 

form of ointment. 
Balsam Copaiba — stimulant alterative — stimulant dim* 

re tick. 
Balsam Peru — antispasmodick — stimulant expectorant. 
Balsam Tolu — stimulant expectorant — external stimu- 
lant. 
Bark Peruvian — tonick — diffusible stimulant, in form of 

tincture, and also the tincture combined with ether. 
Benzoin — expectorant — anodyne, inform of paregorick. 
Balm, the herb — cooling diaphoretick — mild stimulant 

drink. 
Bismuth, white oxyd of — tonick — carminative antacid. 
Bitters, pleasant herbs and roots — tonick, in form of cold 

infusion, tea or powder. 



478 LIST OF MEDICINES. 

Borax — external astringent. 

Burdock — stimulant alterative. 

Calomel — purgative — stimulant alterative einmena- 

gogue. 

Camphor — diffusible stimulant, in form of spirit — sti= 
mulant diaphoretick, in form of powder. 

Caneila Alba — aromatick, but used conjoined with aloes 
only. 

Cantharides — diffusible stimulant — blistering, in form of 
ointment. 

Carduus — touick in form of infusion, cold or warm. 

Chamomile — stimulant diaphoretick — cooling diaphore- 
tick, in form of very weak tea acidulated — tonick. 

Cinnamon — aromatick, antemetick, stimulant. 

Castor Oil — purgative. 

Cherry Bark (wild) — tonick. 

Cephulick Snuff. 

Caustick, Common. 

Caustick, Lunar. 

Centaury — tonick. 

Corrosive Sublimate — stimulant alterative — blistering, 
in form of ointment. 

Contrayerva — stimulant diaphoretick — sudorifick. 

Cremor Tartar — laxative — evacuant alterative. 

Cloves — in powder of bark, tonick and aromatick. 

Cuprum Ammoniacum — tonick. 

Dewberry, root, and leaves — astringent, or restringent. 

Diachylon — used as a strengthening plaster, spread upon 
leather. 

Dogwood — tonick. 

Elm, Slippery — alterative — expectorant — nutrient — and 
used in diluent drink — also diuretick — dietetick. 

Ether, Vitriolick — diffusible stimulant — antispasmodic^ 

Extract of Bark — tonick. 

Extract of Hemlock — stimulant alterative. 

Gamboge — purgative. 

Garlick — diffusible stimulant — antispasmodic^ — vermi- 
fuge. 

Ginger — stimulant, aromatick, dietetick. 

Gentian — tonick. 



LIST OF MEDICINES. 4*79 

Ground Ivy — cooling diaplwretick, acidulated — mild sti- 
mulant drink. 

Gum Arabick — diuretick — medicinal nutrient — diluent 
in drink. 

Guaiacum — stimulant alterative, in substance, and in 
form of tincture — emmenagogue.. 

Hartshorn, Spirits of — diffusible stimulant — expectorant. 

Hellebore — errhine, in form of cephalick snuff- — for itch 
in ointment. 

Heira Picra — purgative — laxative. 

Horehound — tonick and pectoral, and, therefore, only 
proper in coughs, &c. of some standing. 

Iceland Moss — restringent — dietetick, or medicinal nu- 
trient — mild tonick. 

Iron Filings — tonick — vermifuge — emmenagogue. 

Iron Rust — tonick — vermifuge — emmenagogue — stimu- 
lant alterative, in form of muriated tincture. 

Ipecacuanha— emetick — sudorifick, in form of Hovers 
powder — stimulant diaphoretick, with nitre — evacuant 
alterative, with sal. nitre — febrifuge. 

Hog's Lard — used in most ointments. 

Sugar Lead — antihemorrhagick — antispasmodick—-- ex- 
ternal astringent, in form of lead water — ophthalmick. 

White Lead — external astringent, in form of ointmentc 

Laudanum — diffusible stimulant — antispasmodic^ — an- 
tihemorrhagick — anodyne — restringent. 

Lime w r ater — restringent — external astringent — antacid 
lithontriptick — antemetick with milk. 

Liquorice — expectorant. 

Lavender, compound spirit of — diffusible stimulant — an- 
tispasmodick. 

Magnesia — laxative — lithontriptick — antacid. 

Maguesia Calcined — antacid — laxative. 

Madder — emmenagogue. 

Manna — laxative — purgative. 

Mallows, March — refrigerant diuretick — medicinal nu- 
trient — diluent, in drink. 

Mercurial Pills — stimulant alterative. 

Mercurial Ointment — stimulant alterative, in acute dis- 
eases; sometimes highly stimulant — ophthalmick in 
venereal inflammation. 



480 LIST OF MEDICINES. 

Mezereon — stimulant alterative. 

Mustard — external stimulant — stimulant alterative — an- 
tispasmodick---ernmenagogue. 

Myrrh — stimulant alterative — external stimulant, and 
astringent, applied to languid sores, or carious bone. 

Nitre Sal. — refrigerant diuretick — cooling diapboretick 
—febrifuge, in form of powder, and mixture — evacu- 
ant alterative with ipecacuanha. 

Nitre, Sweet Spirit of — antispasmodick — stimulant dia- 
phoretick — stimulant diuretick — febrifuge, in small 
doses. 

Nitrick Acid — tonick. 

Oil Cinnamon — good for tootbach, aromatick, antemetick. 

Oil Savin — external stimulant, in ointment. 

Oil Spearmint — antemetick — carminative stimulant. 

Oil Peppermint, mostly mixed with spirits wine, and call- 
ed essence of peppermint — stimulant diaphoretick — 
diffusible stimulant — carminative stimulant. 

Oil Pennyroyal — emmenagogue — powerful stimulant di- 
aphoretick, in form of weak tea. 

Oil Amber — antispasmodick — diffusible stimulant. 

Oil Anise — aromatick — carminative stimulant. 

Oil Fennel — aromatick — carminative stimulant, used iu 
Godfrey's cordial as an anodyne. 

Oil Almonds — emollient — ophthalmick. 

Oil Linseed, cold-drawn — external astringent with lime 
water, good for burns — supposed to be expectorant. 

Oil, Sweet, or Olive — emollient — external astringent, in 
form of liniment with lead. 

Oil , Wormseed — vermifuge — stimulant. 

Oak B;irk — tonick — restringent — external astringent. 

Opium solid — diffusible stimulant — antispasmodick — 
anodyne antihemorrhagick — restringent. 

Orange Peel — tonick — slightly aromatick. 

Oris Root — used for children who are teething; perfume 
in dentifrice. 

Ointments. 

Pennyroyal. See the Oil of. 

Paregorick — expectorant — anodyne. 

Precipitate, Red; used in ointment fox itch, and languid 
or foul sore«r. 



LIST OF MEDICINES. 481 

Precipitate, white; used in ointment, for itch and herpe- 

tick eruptions. 
Pink, Carolina, or Worm — vermifuge — slightly narco- 

tick. 
Pitch, Burgundy — stimulant plaster, on leather, for hoop- 
ing cough, &c. 
Poke — stimulant alterative. 
Pine Knot Shavings — stimulant alterative. 
Prickly Ash Bark — stimulant alterative. 
Prickly Ash Berries — powerful stimulant, used in tinc- 
ture for tooth ach. 
Poppies — emollient, and anodyne, used in form of bath. 
Quicksilver. — See mercurial pills, and ointment. 
Quasia Wood — tonick. 
Rhubarb — purgative — laxative. 
Rue Juice — antispasmodick — vermifuge. 
Rose Water — ophthalmick — -slightly astringent; leaves 

restringent. 
Rosin, White, or common; used in stimulant or drawing 

ointment. 
Sago — medicinal nutrient. 

Salts, Glauber purgative evacuant alterative, in 

Kuhn's powders. 
Sal. Epsom — purgative; said to allay colicky pains. 
Sal. Rochelle — purgative; in general preferable to Glau- 
ber's salts. 
Sal. Tartar — carminative antacid — febrifuge in saline 

mixture — refrigerant diuretick — lithontriptick. 
Sal. Soda — the same as sal. tartar, but less offensive to 

the taste. 
Saffron, English — stimulant diaphoretick — cordial. 
Sassafras Bark — stimulant alterative — aromatick. 
Sarsaparilla — stimulant alterative, properties weak and 

doubtful. 
Senna — purgative. 
Snakeroot, Virginian — sudoriiick — tonick- — stimulant 

diaphoretick, in form of weak tea. 
Snakeroot, Seneka — expectorant — stimulant diaphore- 
tick. 

01 



48& LIST OF MEDICINES. 

Squills — expectorant, combined with sal. nitre or calo- 
mel, or both, also in form of syrup — diuretick in vine- 
gar. 
Spanish flies — see cantharides. 
Sweet spirit of nitre — see nitre, spirit of. 
Savin — see oil of. 
Sulphur flowers of — laxative — evacuant alterative — used 

for itch, in form of ointment. 
Tartar Emetick — emetick — febrifuge — diaphoretick — 

evacuant alterative, in form of Kuhn's powders. 
Turpentine, spirits — stimulant diuretick — diffusible sti- 
mulant, used as an external stimulant in ointments. 
Tartar vitriolated — used in Dover's powder. 
Uva ursi — restringent — tonick lithontriptick. 
Vitriol, blue — astringent in bleeding from the nose — es- 
char otick. 
Vitriol, white — emetick — restringent — antihemorrha- 

gick. 
Valerian — antispasmodick — slightly tonick. 
Vitriolick acid — tonick — restringent — carminative anta- 
cid. 
Wax, white and yellow r — used in ointments. 
Wine — cordial — diffusible stimulant — stimulant altera- 
tive. 
Wormseed — vermifuge — see oil of. 
Zink, flowers of — tonick — cosmetick. 

Let it be observed, that, in the foregoing treatise on 
diseases, and also in this dispensatory, the doses mention- 
ed are intended for persons of adult years, unless express 
mention is made of children. 

Many attempts have been made at fixing precise doses 
for persons according to age, &c; and physicians some- 
times obtain credit for a studied measuring of doses, &c. 
But nothing can be more preposterous, nothing more un- 
wise; and every person of good sense must be sensible, 
that much depends on the constitution, and on the state 
of the body present. Thus a dose of opium which 
would procure sleep at one time, would produce deli- 
rium at another, in the same person. One ounce of cas- 
tor oil, or one grain of tartar emetick, will produce more 
effect at one time than three or four times that quantity 



LIST OF MEDICINES. 483 

at another, in the same person. I have heen long so sen- 
sible of this, that I have considered it a matter of great 
importance to divide all active medicines into two or three 
portions, and give them a few minutes apart, instead of 
giving all at once, as commonly practised. But, although 
I am so well convinced of the uncertainty of the effects 
of a given quantity of an active medicine, still I beg leave, 
in the most solemn maimer, to caution every person from 
giving medicine, without making it a matter of conscience^ 
to weigh or measure it with the greatest precision; and 
then, by repeating in small doses, every reasonable wish 
can be obtained. 

As a general rule, the following table of doses will be 
quite sufficient; but much must always be left to the judg- 
ment of the prescriber, who alone can judge of the con- 
stitution, and state of the case: 

A person from fourteen to twenty years of age, may 
take two-thirds of a dose intended for an adult. 

From nine to fourteen, one-half. 

From six to nine, one-third. 

From four to six, one-fourth. 

From two to four, one- sixth. 

From one to two, one- tenth. 

Below one year, a twelfth. A woman, generally^ 
should take a little less than a man. 
Apothecaries' Weights. 

A pound contains twelve ounces. 

An ounce — eight drams. 

A dram — three scruples. 

A scruple — twenty grains. 

Measure for Liquids. 

A pint contains sixteen ounces. 

An ounce — eight drams. 

A table spoonful is about half an ounce. 

A tea spoonful is one fourth of a table spoonful, 

Sixty drops make one tea spoonful 



484 OF PURGATIVES. 



SECTION II. — SUBSECTION 1. 

Of Purgatives. 

These are a valuable class of medicines, and are found 
in abundance in both the mineral and vegetable king- 
doms. I however, have chosen to select a few of those 
with which I am best acquainted; and which the present 
practice sanctions more particularly: they will be found 
amply sufficient. 

Aloes. 

Three kind of aloes are met with in the shops, dis- 
tinguished by the names of Socotorine, Hepatick, and 
Fetid. It is only necessary to choose that which is clean 
and freest from smell. The socotorine is generally most 
agreeable. This article forms a part of almost every 
patent pill. Aloes is seldom given alone; it may be com- 
bined with calomel, jalap, rhubarb, and also with canella 
alba. It is principally given as a laxative. Dose from 
from two to ten grains. Aloes is supposed to operate 
principally on the lower intestines, and therefore is an 
improper laxative for persons subject to piles. 

Calomel. 

Calomel has long maintained the character of being a 
valuable medicine. The illustrious Sydenham gave a 
scruple at a dose. In bilious diseases, in dropsy, malig- 
nant fevers, malignant sore throat, our summer diseases 
generally, in the croup, &c. calomel is an invaluable me- 
dicine. It is seldom given alone as a purge, but may 
be conjoined with jalap, rhubarb, aloes, and, in short, 
with almost every purgative. This medicine is a valua- 
ble one for children, and perfectly safe, provided we do 
not continue it long. Dr. Rush tells us several de- 
plorable accidents followed its use with children at Phi- 
ladelphia. Dose from two or three grains to twenty; five 
grains, combined with some other purgative, is the most 
usual dose. 

Jalap. 

This is an active and valuable article. It is used prin- 
cipally in the form of pills or powder, but is apt to nause- 



OF PURGATIVES. 485 

ate the stomach when given alone. It may be taken 
with calomel or cremor tartar. Dose from twenty to 
thirty grains for healthy persons. Weakly persons sel- 
dom require the use of jalap. 

Rhubarb. 

The best rhubarb is imported, and is called Turkey 
rhubarb. It is a mild purge, and may be combined to 
advantage with calomel, magnesia, &c. Dose from twen- 
ty to forty grains, in pills or powder. 
Castor Oil. 

Castor oil is a valuable purge. It should be chosen 
clear and light coloured, with but little smell; the best 
has neither much smell or taste. Dose from one to three 
table spoonfuls; and it may be made less offensive to 
the taste, by taking it on some warm liquid, as wine 
and water, weak toddy, coffee, or a little warm water 
sweetened. 

Gamboge. 

Gamboge is never given alone, but may be combined 
with most of the other purgatives. Where the bowels 
are insensible to less active articles, this is an excellent 
auxiliary. Much, however, depends on the grinding 
of it: if it is ground to a powder completely impalpable, 
it will seldom nauseate the stomach, or gripe, but is 
speedy and safe in its operation. Dose from one to five 
grains, 

Glauber Salts. 

Glauber salts is an excellent purgative. It operates 
mildly and effectually; but its unpleasant taste is a pow- 
erful objection against it, with many persons. It is sup- 
posed that it disposes to costiveness. It may be mixed 
with senna, manna, &c. Dose from one to three table 
spoonfuls. This medicine should be strained after it is 
dissolved, and the cleanest should be carefully sought 
after when buying it. 

Rochelle Salts. 

Rochelle salts is so similar to glauber salts, that it may 
be used in its stead. The taste is less offensive than that 
of salts. I think it better than salts in general, if it were 
only for its being cleaner: but independent of this, I can. 



486 



OF PURGATIVES, 



with confidence, recommend Rochelle salts as a most in- 
valuable purge. Dose from six to twelve drams. 
Epsom Salts. 

Epsom salts is entirely different from glauber and ro- 
chelle salts in its constituent parts, but is nearly similar 
in its properties and strength. It has been supposed that 
this medicine allays the pain of colick, independent of its 
purgative operation. It has more of the bitter, and less 
saltish taste than Glauber's salts, which is sometimes sold 
for it. The salts is rendered similar to it in appearance, 
by shaking the vessel while the common salts is chrysta- 
lizing, and thus making the chrystals smaller. Dose 
from six to twelve drams. 

Senna. 

Much has been said in favour of the Alexandrian sen- 
na; but from considerable experience, I feel full assu- 
rance in saying, that there is little or no difference. 
Choose senna that is clean and free from stalks, and you 
will find it answer your wishes as a mild purgative. It 
is mostly combined with other articles, as salts, rhubarb, 
manna, &c. Its tendency to griping may be obviated 
by a little coriander seeds, or a few grains of soda. Dose 
from one to three drams in decoction. 

Manna. 

Two kinds of manna are met with in the shops, called 
flake, and manna in sorts. This medicine is never given 
alone to adults, but to very young children it is sometimes 
given, dissolved in warm water; for this purpose a dram 
may be dissolved, and a few tea spoonfuls given every 
hour till it operates. Manna is said to be adulterated by 
adding sugar and a little of some active purgative, as 
scammony, &c. and therefore we should endeavour to 
procure that which has been tried, before we give it to 
tender infants. 

Heir a Pier a. 

Heira picra may be made by mixing four ounces of 
best aloes with one ounce of cannella alba; both these 
articles should be well ground, separately. This medi- 
cine is used principally, dissolved inspirits of some kind, 
and is an useful purgative or laxative, for persons in the 
decline of life, but should ^iot be touched by young per 



OF PURGATIVES. 487 

sons, more espesially when dissolved in spirits. Heira 
picra may be mixed in the proportion of an ounce to a 
quart of good rye whiskey or rum. Dose from a half to 
two table spoonfuls, observing to shake the bottle before 
pouring out 

Tincture of Rhubarb and Senna. 
Tincture of rhubarb and senna may be made thus: 
take rhubarb in coarse powder two ounces, senna a little 
bruised one ounce, ginger two drams, proof spirits one 
pint. Dose from one to three table spoonfuls. It is a 
valuable purgative for the aged, or persons intemperate in 
the use of ardent spirits; but should never be given to 
people of any other description. It should be strained, 
after infusing eight or ten days. 

Purging Pills. 
Jalap, twenty-five grains, > Moisten with a little mo- 
Calomel, five grains. 3 lasses, thin paste, or water, 
and make eight pills; take five, and if they do not purge 
the patient in two or three hours, take the remainder. 
When they operate, drink weak sage, green, or balm 
tea, or thin gruel. 

Purging Pills with Moes. 
Jalap and Rhubarb, each ten grains, ) Grind the aloes, 
Calomel and aloes, each five grains. 3 an d m i x w ^h the 
other ingredients, and make eight pills, as above direct- 
ed: they are to be taken as the purging pills above. 
Purging Pills with Gamboge. 
Jalap, twenty grains, 7 Grind the gam- 

Calomel, Gamboge, each five grains. 3 boge with great 
care, as fine as possible, and then mix and make eight 
pills, which are to be taken as the above purging pills: 
these are an active and useful purgative for persons of 
athletick habits. 

Purging Infusion. 
Senna, Rhubarb root, each one dram, 7 Pour a pint of 
Salts and Manna, each two drams. 3 boiling water 
on the ingredients, keep it at the fire half an hour; take 
from half to a whole tea cupful, every two hours, till 
it operates freely. Weak tea, or thin gruel, may be 
drank; or persons free from fever may use weak chick- 
en water. 



488 -" OF LAXATIVES. 

Infusion of Senna. 
Senna, three drams, } Infuse in a pint of boil- 

Cremor Tartar, one dram, > ing water, and take 
Coriander seeds, half a drain. ) from half to a whole 

tea cupful every hour or two till it operates; it may be 

sweetened with sugar or manna. 

subsection 3. 
Of Laxatives. 

Laxatives are so similar to purgatives, that I have 
placed them in the same section; but as the former are 
used with different intentions from that of purgatives, I 
have thought best to place laxatives by themselves. It is 
true, many articles may be used with propriety either as 
purgatives or laxatives, but there are many others which 
are only suited to one intention; thus, sulphur, cremor 
tartar, &c. are laxatives. Calomel, jalap, senna, &c. are 
purgatives. A laxative, strictly speaking, is an article 
not only mild in its operation, but ought to be such as 
may be used for a length of time with safety, and I have 
had regard to this circumstance in selecting. 
Cremor Tartar. 

Cremor tartar is an excellent laxative. It may be 
taken in doses of from one to three tea spoonfuls, in mo- 
lasses, or made into a paste with sugar and water; or two 
drams put into a pint of boiling water, and taken in do- 
ses of a wine glass, and it may be sweetened with brown 
sugar. This article should never be put into any metal- 
ick vessel. 

Flowers of Sulphur. 

Flowers of sulphur is a useful and safe article, and 
is particularly proper for the gouty or rheumatick. It 
may be taken in molasses or syrup, in doses of from one 
to four tea spoonfuls. It may be combined to advantage 
with cremor tartar. This article should be chosen free 
from acid taste. 

Magnesia. 

Magnesia should be perfectly white, free from gritti- 
ness, and lighter than any other article which it resem- 



OF LAXATIVES. 489 

bles. This, in many cases, is a very valuable laxative, 
but is only so where acidity abounds; for it only operates 
as a laxative when changed by the acid of the stomach 
into a neutral salt. When it is used as a laxative, it 
ought in general to be conjoined with rhubarb. Dose 
from one to three tea spoonfuls. It may be made into a 
thin paste with water, and a little sugar added, if desir- 
ed: many persons can take it in a dry state, and this is 
probably the best. 

Rhubarb Root. 
Rhubarb root simply chewed, or in syrup, is a good 
laxative. 

Syrup of Rhubarb. 
Rhubarb in powder one ounce, 7 Pour a pint of boiling 
Race ginger two drams. 5 water on the ingre- 

dients, and keep it warm half a day, then strain through 
a linen rag, and add ten ounces of best brown sugar. This 
is a good laxative for children. Dose from one to five 
tea spoonfuls. 

Bitter Tincture of Rhubarb. 
Rhubarb one ounce and a half, 7 Put the ingredients 
Grentian sliced, three drams. 5 "^o a pint of good 
whiskey or rum, infuse a week, and strain. This is an 
useful laxative for persons of weak stomach, but more 
particularly for persons accustomed to the free use of ar- 
dent spirits. Dose from one to four table spoonfuls. 
Laxative Fills. 
Socotorine aloes, ~) p . , ." 

Rhubarb and castile soap, each two drams. 3 n 
aloes, then mix the whole with a little syrup, or molasses, 
and make seventy-two pills. This is a useful laxative for 
persons habitually costive, and will answer as a substi- 
tute for Anderson's, Fisher's, and other pills. Dose 
from one to six. 

Heira Picra. 
Heira picra is a good laxative for the aged, dissolved 
in spirits; one ounce may be dissolved in a quart of 
whiskey or rum. It ought by no means to be given to 
children, or young people. Dose from a half to two ta- 
ble spoonfuls. 

62 



400 &T EMETICKS. 

Laxative Potion. 
Salts, manna, each two drams. Dissolve in a little 
warm water, and take it at one dose. This is a valua 
ble laxative, after colick, fevers, &c. 

section in. 
Of Emeticks. 

A great variety of articles may be used for this pur- 
pose, but with these, as with all other articles possessing 
considerable activity, the safest method is to choose a 
few only, which are well known from long experience. 
The present practice gives preference to the following, 
and they are all articles of which I have had considera- 
ble experience; they are ipecacuanha, white vitriol, 
(sulphat. zink,) and antimonials. Vomits prudently 
used, are sometimes highly beneficial, but a frequent 
repetition of them, or strong vomits, may be productive 
of very great mischief; and, therefore, I would advise the 
unskilful never to tamper with emeticks: purges, parti- 
cularly pills, containing a little calomel, are often better, 
and I can confidently assert, there is less risk of taking 
cold from using calomel prudently, than there is from 
taking vomits. 

Ipecacuanha. 

Ipecacuanha is a medicine of very great value. It 
flMfy be given with safety in all cases where a vomit is 
necessary; for strong habits, a grain of tartar emetick 
may be added. Dose from one to two scruples, in two 
doses a few minutes apart. It is only where we wish 
to reduce the patient, that large draughts of warm water 
are necessary during the operation of vomits; in general, 
a little weak chamomile, sage, or very weakcarduus tea, 
is preferable. 

White Vitriol. 

White vitriol is particularly useful as an emetick, on 
account of its quick operation. Where poisons have 
been swallowed, or in all cases where we merely wish 
to empty the stomach speedily, this is a valuable medi- 
cine. I have also thought it most useful, from many 



SUD0RIF1CKS. 491 

trials, in agues; but where we wish to open the skin, 

ipecacuanha is mostly better. Dose from one to two, 

pr even three scruples dissolved in a little warm water 

JLntimonial Wine. 

Antimonial wine is a useful emetick in cases of sud- 
den attacks of croup, erysipelas, &c. and may be given 
in most cases with safety to children, or adults, of good 
constitution, but should never be given to weakly chil- 
dren or adults. This article is made by dissolving two 
scruples of tartar emetick, in two ounces of warm water, 
and then adding it to a pint of Lisbon wine. Dose from 
half to two table spoonfuls at two or three doses, taken 
a few minutes apart. 

Tartar Emetick 

Is seldom used as an emetick by cautious experienced 
physicians; but to labouring people, of gross strong ha- 
bits, it may be given sometimes to advantage; but upon 
the whole I am convinced the practice of medicine would 
lose nothing by laying aside full doses of tartar as a 
vomit. Dose from two to six grains, in three or four 
doses a few minutes apart. Where this medicine is ne- 
cessary or advisable as a vomit, warm water should be 
drank freely. 

Emetick Powder. 

Ipecacuanha, one dram, 7 Rub these ingredients well 

Calomel, half a dram. 5 together, and put it into a 
vial. This will be found a valuable medicine in croup, 
malignaut sore throat, &c. Dose from thirty to forty 
grains: for children see table of doses. 

SECTION IV. SUBSECTION 1. 

Sudorificks. 

A great number of articles have long since been se- 
lected from the vegetable, animal, and mineral king- 
doms, and used as sudorificks, or as things having a 
teudency to cause sweating. But, perhaps, no class of 
medicines are more uncertain in their operation, for much 
depends on the state of the system at the time they are 
given. Still, however, by knowing the state suited to 



493 SUDORIFICKS. 

such medicines ; we can administer them with considera- 
ble certainty. Let it be remembered, that where there 
is much fever, or where an inflammatory diathesis is pre- 
sent, sudorificks should not be given, for in this state of 
the body, bleeding, purging, cool drinks, cool air, and 
abstinence, will open the skin, and bring on a gentle 
perspiration, or even sweating, while common sudorificks 
are sure to increase the fever; but when the body is 
somewhat reduced, or in diseases of feeble action, as low 
typhus, or typhoid fevers, or in all febrile diseases af- 
ter suitable depletion, or reduction of the patient, sudo- 
rificks or diaphoreticks are useful, and often indispen- 
sable. In chronick inflammation, as in chronick rheu- 
matism, vibrating gout, sudorificks may often be used to 
advantage. 

Virginian Snakeroot. 
This is a useful sudorifick in all low fevers, or at the 
close of malignant diseases. It may be used in all 
cases where we wish to soften the skin, while we at the 
same time intend to support the tone of the solids in a 
slight degree. It is often given with advantage con- 
joined with bark, or nitrous, or camphor powders. This 
article is destroyed by boiling, or by long standing; 
therefore but very small quantities of tea should be made 
at once, and this should be put into boiling water and 
closely covered. It may be ground fine, and mixed 
with bark or other bitters; but the powder should not 
be kept; it soon loses its properties. 
Dover's Powder. 
Ipecacuanha, Opium, each one part, 7 The driest opi- 
A 7 itriolated Tartar, eight parts. 3 um should be 
chosen, and the greatest possible pains taken to grind 
the mass to a completely fine powder. This is proba- 
bly the best sudorifick known. Dose from eight to 
twenty grains, and the patient should avoid drink for 
an hour or two after taking it; then large quantities of 
cremor tartar whey, milk whey, wine whey, &c. accord- 
ingly as the disease is viewed as being more or less in- 
flammatory are to be taken. 



STIMULANT DTAPHORETICKS. 483 

Contrayerva. 

Contrayerva root may be used as snakeroot, in tea, or 
decoction. It may also be given to advantage in doses 
of about from twenty to thirty grains, ground fine, and 
mixed with an equal quantity of prepared chalk. This 
is a useful medicine in low fevers. 

Seneka Snakeroot. 

Seneka snakeroot is generally given in decoction: two 
drams may be boiled for some time in half a pint of wa- 
ter. Dose one or two table spoonfuls. This is a use- 
ful medicine for children in the close of croup. Chil- 
dren are to take it in doses of one or two tea spoonfuls f 
frequently repeated. 

subsection 2. " 

Stimulant DiaphoreticJcs. 

Stimulant diaphoreticks are very little different from 
sudorificks. Some articles, however, in this class are 
more heating when given with freedom, some less so, 
while others may be used with either intention, as we 
make the doses stronger or weaker. Most of the arti- 
cles set down as stimulants are better suited for exci- 
ting a slight moisture on the skin than for sweating; and 
this is only to be expected of them after the body is re- 
duced by more active evacuants. 

Camphor Powder. 
Camphor half a dram, ~) Grind the camphor with a few 
Sal. nitre one dram. 3 drops of spirit of wine, or 
whiskey; rub till nearly dry; then add the nitre; when 
well ground, make six powders. Dose one powder, 
every two, three, or four hours, in water, or weak snake- 
root tea. 

Diaphoretick Powders. 
Sal. nitre one dram, ? Grind fine and make eight 

Ipecacuanha one scruple. 5 powders. Dose one pow- 
der every three or four hours. 



494? COOLING DIAPHORETICKS. 

Sweet Spirit of Nitre. 

Spirit of nitre is a mild diapboretick, but is two stimu- 
lant during an inflammatory diathesis. Dose from twen 
ty drops to two tea spoonfuls. This medicine, combin- 
ed with laudanum in equal parts, is a valuable diapho- 
retick and anodyne, in low cases of fever, and in many 
nervous diseases. 

Contrayerva, weak, ") These are to be used in the 



Snakeroot, Virg. weak, 
Chamomile, weak, 



form of teas, and we are to 
endeavour to regulate them 



Peppermint, weak, ^to the disease, as it is more 



Pennyroyal, very weak, 
Valerian, weak, 



or less inflammatory; in ge- 
neral they ought to be very 



Saffron, very weak, J weak; for if we wish to sti- 
mulate, more active articles should be chosen. They 
should be made by pouring on boiling water, and but 
small quantities at a time. 

Spirit of Hartshorn. 

Spirit of hartshorn is a warm diapboretick, and only 
admissible where the disease is of a low grade, or has 
lost its inflammatory force. Dose from five to twenty- 
five drops, in cool water. 

subsection 3. 

Cooling Diaphoreticks. 

Cooling or refrigerant diaphoreticks, are articles which 
may always be given in diseases of moderate or mid- 
dling grade, and in delicate habits, in most diseases 
from the first, even in inflammatory diseases. These 
are articles which promote perspiration, by lessening 
heat, or morbid action. And it may be proper here to 
observe, that all evacuants, as bleeding, purging, &c. as 
well as cool air, cool weak drinks, are always followed 
by diaphoresis, or a moist skin, provided they are carri- 
ed far enough, aud, therefore, in inflammatory diseases 
are the best diaphoreticks. 



EXPECTORANTS. 41)5 

Sal. Nitre. 
Sal. nitre, taken in doses of from five to twenty grains, 
is cooling and diaphoretick. It may be given with a dou- 
ble portion of cremor tartar, for the same purpose. 
JSTitro u s Mixture . 
Sal. nitre, two drams, 1 Rub the ni- 

Vinegar, two table spoonfuls, I tre and su- 

Sugar, or sugar candy, half an ounce, j gar in amor- 
Water, fresh and cool, 12 table spoonfuls, j tar, and then 
add the liquids. Dose, a table spoonful every two 
hours. 

Cremor Tartar. 

Cremor tartar, two drams, 7 This is a useful cooling 

Boiling water, a pint. 3 medicine, very mild, and 

when a little sugar is added, is a pleasant diaphoretick. 

Dose, a wine glass frequently. This article must be 

kept in an earthen, or glass vessel. 

Spirit Mindererus. 
Best vinegar three parts, ? Mix in small quantities. 
Spirit hartshorn one part. 5 and give from one to three 
tea spoonfuls, once in every two or three hours. This 
is a valuable medicine, and may be given early, even in 
inflammatory diseases; in those of the typhoid grade, it 
is generally highly beneficial. 

Balm tea, very weak, "1 These should be taken 

Ground ivy tea, very weak, I largely, but must be 
Elder blossom tea, weak, 'made very weak, and 
Chamomile tea, very weak.^ taken tepid, or cool, 
and acidulated with a little lemon juice, or vinegar, or 
they will stimulate. 

section v. 

Expectorants. 

Expectorants are medicines supposed to operate on 
the viscera of the chest, but their effects depend much 
on the state of the system, so that what would be expec- 
torant in one case, might prove injurious in another dis- 
ease of a different grade. But, however much we may 
be at a loss to explain, or understand^ the manner of 



496 EXPECTORANTS. 

operation, still long experience establishes the fact, that 
some articles when properly adapted to the condition of 
body present, do promote expectoration or spitting, and 
thus relieve the lungs of a part of effusions into them. 
We find articles in this class very different, as to stimu- 
lant properties, but, I have thought proper to place them 
all under one head. It may be observed, that the most 
stimulant are placed first, and their stimulant properties 
diminish downwards. Where there is evidence of much 
inflammation we are not to use stimulant expectorants; in 
this condition of the system, bleeding, and other active 
evacuants, are the best expectorants. 

Squills. 

Squills may be given in powder, ground with a little 
sal. nitre; from half a grain to three grains, repeated eve- 
ry few hours; or a grain or two of calomel may be given 
with the squills in obstinate cases of pneumonia. 
Stramonium, or James Town Weed. 

This article smoked in a pipe, as people use tobacco, 
is a powerful expectorant, in cases of confirmed asthma. 

Balsam Peru, ~) These are warm expectorants, and 

Balsam Tolu. 5 sometimes useful in old coughs, or af- 
fections of the breast, without active inflammation. Dose 
from ten to thirty drops on a little sugar. The tolu is 
often dry or in form of a resin; in this state it may be ta- 
ken in pills from three to twenty grains the dose. 
Ammoniac um. 

Ammoniack, a gum-resin, is a good expectorant. Dose 
from ten to thirty grains: or it may be dissolved in vine- 
gar, and taken diluted with a little water. 
Spirit Hartshorn. 

Spirit of hartshorn may be given as a stimulant expec- 
torant, in doses of from five to twenty-five drops, in cool 
water. 

Syrup of Squills. 

Steep half an ounce of squills in half a pint of good 
vinegar, and two spoonfuls of spirit, or whiskey. Let it 
steep four days, then strain, and add to the strained li- 
quor, half a pound of loaf sugar. This is a useful ex- 
pectorant, for children. Dose for adults, from two to five 
tea spoonfuls. 



STIMULANT DIURETICKS. 497 

Paregorick. 

Paregorick elixir is expectorant, and anodyne^ in do- 
ses of from one to three tea spoonfuls. 
Seneka Snakeroot. 

One or two drams of Seneka root, boiled for a few 
minutes ill half a pint of water, is an expectorant. Dose 
from two to six tea spoonfuls. 

March Mallows. 

March mallows, either in simple tea, or sweetened with 
honey, or sugar candy, and taken tepid or warm, is a mild 
expectorant. 

Slippery elm bark, 1 These are all mild expecto- 

Flaxseed tea, I rants. The elm may be 

Liquorice root tea, with j used by simply mixing a 
a little nitre in it. J little of the ground bark 
in water, and it may be rendered pleasant by adding a 
little sugar and vinegar. 

Flaxseed tea should not be too slimy, neither must the 
seed by any means be roasted, as is practised in the 
country; this wholly changes the properties of it; and it 
is no longer expectorant. A little hysop, sage, or ground 
ivy, will render it more pleasant. Honey is supposed 
to be useful in all expectorant drinks. 

SECTION VI. SUBSECTION 1. 

Stimulant Diureticks. 

Horseradish is a powerful diuretick. It should be 
grated, and taken in vinegar; a table spoonful or more 
may be taken. It may be taken in its raw state grated, 
and rolled in a little pap, or thickened milk. 
Sweet Spirit Nitre, 
In doses of one or two tea spoonfuls, taken in cool 
water, is- a valuable diuretick; and although considera- 
bly stimulant, when much fever is present, is, neverthe- 
less, a mild article in cases of strangury from blisters, &c. 
Spirit Turpentine. 
Spirit turpentine, in the decline of life, and where the 
urinal organs are somewhat palsied, is a e;ood stimulant 
63 



-198 GLYSTERS, OR INJECTIONS. 

diuretick, but is inadmissible in any other condition of 
the body. Dose from ten to thirty drops on sugar. 
Balsam Copaiba. 

This is somewhat similar to the spirit turpentine, but 
is less stimulant, and being laxative, renders it a valua- 
ble medicine in a languid state of the kidneys, in gleets, 
fluor albus, &c. 

Vinegar of Squills. 

For the preparation of this article, see expectorants. 
The vinegar of squills may be given in doses of from 
half to one table spoonful; but, where we wish to avoid 
nausea, we should combine it with cinnamon. This 
remedy is best suited to cases somewhat chronick, as in 
dropsy, &c. it being considerably stimulant. 

subsection 2. 

Refrigerant, or cooling DiureticJcs. 

These are medicines which promote or increase the 
quantity of urine, without heating the body, or increas- 
ing the circulation. 

Sal. JVitre, 
Given in doses of from five to twenty grains, dissol- 
ved in cool water, or a little vinegar and sugar may be 
added. It may also be given in parsley or flaxseed tea. 
Saline Mixture. 
Salt tartar, or soda, one dram, dissolved in half a pint 
of water; then, add lemon-juice, lemon acid, or nice vi- 
negar, gradually, till it ceases to effervesce. Dose two 
table spoonfuls, often repeated. 

Parsley root, in tea,^j Are mild and useful diureticks: 
March mallows tea, > they may be taken cool, or te 
All mild mucilages, J pid, pretty freely. 

SECTION VII. 

Glysters, or Injections. 

Glysters are of vast importance in the practice of me- 
dicine; and many are lost by the neglect of this invalua- 



GLYSTERS, OR INJECTIONS. 499 

ble mode of administering remedies. Were I confined 
to one remedy for the cure of diseases, I should choose 
glysters. They are not only safe, but highly useful in 
every disease, in its forming stage. In dysentery, and 
many other diseases, no physician can acquit his con- 
science for an omission of this remedy. Every family 
should have an apparatus for this purpose, and view it as 
a matter of the highest importance to keep it in clean 
complete order. The best way, in general, is to have 
a syringe fixed in a stool; this enables the patient to use 
it without assistance, and this kind of syringes are to 
be had for a small sum, at the apothecaries, made of 
pewter, and are easily connected to a bench or stool. 
But for children, or those who are too weak to sit up, 
the common instrument made of a bladder and a small 
ivory pipe, should always be in readiness. All heads 
of families should make it a matter of the greatest im- 
portance to save bladders in time of killing. There is 
no doubt, with me, but a very great number of persons 
are lost every year, in the country, for want of glysters: 
and this want arises from several causes, as the want of 
instruments, want of persons to administer this simple 
remedy, aversion to their use, and an omission on the 
part of physicians, arising, often, from the aversion or 
incapacity in the attendants, and sometimes from the 
want of knowing the vast importance of this remedy. 
In every family oue or more persons should be compe- 
tent to this business. Where modesty is likely to inter- 
fere, a small leather tube may be connected to the blad- 
der and pipe, and carried under the bed-clothes by the 
patient. We are enabled by glysters to evacuate the 
contents of the bowels, to sheath and cool them, and 
thus allay pain and fever, to check a purging, &c. and 
in cases where the patient is unable to take nourishment 
on account of swelling of the throat, or wounds, and 
other causes, we may nourish the patient, and thus save 
life till food can be taken in the usual way. Physi- 
cians! Nurses! Parents! Let me humbly admonish you, 
that this is a most important matter; for I have seen ma- 
ny cases, in country practice, where almost any thing 
would have been given for a bladder which could not 



500 GLYSTERS, OR INJECTIONS. 

be procured, and willingly would a hog, a sheep, or an 
ox, have been sacrificed for the bladder; but this, alas! 
would not answer, because the bladder must be dried. 
If it, then, really be a fact, that a life may be lost for 
want of a bladder, with how much care should we pre- 
serve them! And if they are so beneficial, why so child- 
ishly neglect their use, because, to those unaccustomed 
to them, they seem indelicate; but what has delicacy to 
do with matters which jeopardize human life? 
Emollient Glyster. 
Milk and warm water, of each from a gill to half a pint. 

Another. 
Slippery elm bark, half an ounce, in powder; infuse 
a few minutes in a pint, or a little less, of warm water, 
and strain. 

Another. 
Dissolve a table spoonful of starch in a little warm 
water; when mixed into a smooth paste, add a pint or a 
little less of warm water. All these are convenient and 
useful glysters, in all cases of pain and heat in the bow- 
els, in fevers, dysentery, and many other cases. 
Cooling Glyster. 
Rub a spoonful of starch in a little cool water, then 
add about half a pint of cool water. This is a safe and 
valuable remedy in cases of inward piles, in flux, and in 
all purgings attended with much heat. It is a sove- 
reign remedy in all cases of high fever in children: the 
quantity must be lessened: from half to a whole gill 
will usually answer for children. 

Purging Glyster. 
Salts one ounce, water, warmed a little, nearly a pint. 

Stimulant Purging Glyster. 
Table salt from one to three spoonfuls, dissolve in 
nearly a pint of water. 

Another. 
Senna half an ounce, stew it, for some time, in a pint 
of water, and strain through a rag. 

Laxative Glyster. 
Warm water nearly a pint, sweet oil, or nice fresh 
lard, or fresh butter, a spoonful, sugar or molasses, a 
spoonful. 



EVACUANT ALTERATIVES. 501 

Anodyne Glyster. 

Prepare an emollient glyster, and add from thirty to 
sixty drops of laudanum. This will be found useful in 
lingering cases of flux, &c. 

Stimulant Glyster. 

Prepare a glyster of the usual quantity of water, and 
a spoonful or two of oil, or clean lard; to this, add one 
or two tea spoonfuls of spirits of turpentine. This is 
sometimes useful in paralytick affections, and in the co- 
matose state of low fevers, and also in gout of the intes- 
tines attended with great prostration of strength. 
Nutrient Glysters. 

These are warm milk, broth, barley water, and such 
like. It will readily be perceived by the intelligent 
reader, that almost every article of medicine may be 
administered by way of glyster; and all those forms 
may be varied to suit each individual case. For chil- 
dren of from seven to ten years of age, about half the 
quantities will answer; for those younger or older, we 
must increase or diminish the quantity to suit the age, 
as near as may be, but except it be in the use of lauda- 
num, turpentine and strong medicines, no great precision 
is necessary. 

SECTION VIII. SUBSECTION 1. 

Evacuant Mteratives. 

These are medicines which operate some friendly 
change on the body, by gradual and mild evacuations, and 
ought to be such as may be continued for a considerable 
time, with safety. In diseases of the skin, or in habits 
subject to biles, or piles, and in cases of chronick dis- 
eases, pretty generally, evacuant alteratives are useful. 
In most cases, where we wish to continue them long, 
mild aromaticks, or carminatives should be conjoined. 
Some of these medicines operate on the bowels, others 
on the urinal organs, and others, again on the skin, &c. 
Cremor tartar, } These may be used separately, or 
Flowers sulphur. 3 combined, in doses of from one to 
three tea spoonfuls in syrup or molasses. These are 



502 STIMULANT ALTERATIVES. 

safe and beneficial in all cases where evacuant alteratives 
are proper; but it is to be remembered, that they are in- 
admissible in all cases of great debility. Sulphur alone 
is most useful in rheumatick or gouty habits. 
Nitrous Powders. 
Sal. nitre, one dram, ~) These articles are to be 

Ipecacuanha, one scruple. 3 rubbed fine, and divided 
into eight powders. These powders are a useful evacu- 
ant alterative, in lingering fevers, but cannot be continu- 
ed longer than ten or fifteen days, or they may injure the 
stomach; to be taken every three or four hours. 
Killings Powders. 
Salts, one ounce, "J Grind the salts fine, and 

Calomel, eight grains, > after mixing the whole 
Tartar emetick, one grain. J with great care, make 
eight powders. One or two of these may be taken dai- 
ly in cool water. This medicine may safely be taken for 
several weeks, and is of singular efficacy in rheumatick 
cases, in cases of protracted gonorrhoea, &c. 
Slippery Elm, 
Taken in powder, or in mucilage made by mixing it 
with water, has been found useful in diseases of the skin. 
It may be taken in quantities of from two to four drams 
per day. 

subsection %. 

Stimulant Alteratives. 

Stimulant alteratives are articles which operate on the 
body in a manner somewhat less evident, than evacuant 
alteratives; but as they are evidently different from diffu- 
sible stimulants, and also from common tonicks and as- 
tringents, we must suppose them to have a peculiar ope- 
ration. They are evidently stimulants, but they seem to 
operate more especially on the glandular system: whether 
it be by simply raising the excitement of those parts, or 
whether they produce some specifick operation, calculat- 
ed to remove disease, I shall not venture positively to de- 
termine; but I think we are warranted in saying, some 
of them operate by the second mode. Mercury has a 
specifick operation on syphilis, hemlock on glandular 



STIMULANT ALTERATIVES. 503 

scrofula; but upon the whole, it is probable, stimulant al- 
teratives effect a change on the body, affected with chro- 
nick disease, by keeping up a gentle increase of excite- 
ment in the glands; and thereby enables them to perform 
the important functions of secretion, and excretion: while 
evacuant alteratives accomplish the same ends, by lower- 
ing undue, or a too high excitement of the glands. 

Mercury. 

Mercury is a powerful stimulant alterative, and may 
be given to advantage in both acute and chronick disea- 
ses; but as I have given directions in the various cases 
to which it is applicable when treating on diseases, I 
shall now proceed to mention a few mercurials, which I 
consider most useful and safe, as stimulant alteratives. 

Calomel. 

Calomel combined with opium, and given in small do- 
ses, is a valuable alterative. 

Corrosive Sublimate. 

Corrosive sublimate of mercury, dissolved in whiskey, 
or spirit, has been much celebrated as an alterative, in 
venereal cases. It is certainly a valuable medicine, but 
I suspect calomel and opium will always answer our 
wishes equally well. This medicine has been gene- 
rally given according to the directions of Van Swie- 
ten: corrosive sublimate one grain, French brandy, or 
common spirit, two ounces. Dose a small table spoon- 
ful every morning and evening. I have seen this medi- 
cine continued a long time without any benefit. 
Mercurial Pills. 

Quicksilver, one dram, 1 Add a few 

Conserve of roses, or manna, three drams. _y drops of 
molasses, or water, and rub until no particles of the quick- 
silver can be discovered, by rubbing a little of the mass 
on white paper; then add a little powdered starch, and 
make forty-eight pills. Dose from two to five. 

The alterative effects of all these mercurials are in- 
creased by diet drinks of sassafras, burdock, sarsaparil- 
la, and mezereon. 

Mercurial Ointment. 

Quicksilver, half an ounce, 7 Rub the quick 

• The best fresh hogs lard, two ounces. 3 silver with a lit 
tie of the lard until no globules can be perceived; then 



504 STIMULANT ALTERATIVES. 

mix the whole. For inflammation of the eyes, this oint- 
ment should be fresh made; but in fevers, &c. that has 
age will be best. It is a dangerous, slovenly, and un- 
necessary method of using mercury, for persons going 
about; but in fevers or other cases, where the patient is 
confined to the house, and we wish to salivate speedily, 
it is a most invaluable stimulant alterative. 
Hemlock, or Cicnta. 
Hemlock is best used in the form of extract; and it is 
particularly to be remembered, that no two parcels of this 
article have equal strength; and, therefore, with new par- 
cels, the patient must always begin with small doses, 
and increase them gradually. The most respectable au- 
thority advises this medicine in cases of scrofula. Dose 
from two grains to one dram, usually given twice a day. 
The extract made by boiling the juice of the plant to a 
thick syrup, and then adding of the powdered leaves till 
the mass becomes pretty solid, is the best. 

Guaiacum. 
Guaiacum, the gum resin, is a valuable stimulant al- 
terative in many chronick diseases, but particularly in 
rheumatick and gouty affections, and also in some uterine 
affections. It may be given in substance, in doses of 
from twenty to forty grains. 

Tincture of Guaiacum. 
Guaiacum, one ounce, } Pound the guaiacum and 
Good whiskey, one pint, V alspice, then infuse them 
Alspice, two drams. ) in the whiskey eight days, 

and strain. Dose from one to three tea spoonfuls: it is 
most pleasant taken in milk; and where we wish it to act 
as a diffusible stimulant, a few drops of spirits of harts- 
horn may be added to each dose: this addition is some- 
times useful in cases of painful menstruation. 
Muriated Tincture of Iron. 
The muriated tincture is certainly entitled to the cha- 
racter of a stimulant alterative; for the quantity of spi- 
rits, or etherial liquor which is formed in preparing it, 
being so small in a dose, we must view it as a chaly- 
beate. Rust of iron two ounces, muriatick acid six 
ounces, spirits of wine three gills; digest the rust in the 
acid three days in a glass vessel; pour off the clear liquor, 



STIMULANT ALTERATIVES. 505 

and evaporate nearly one half, (a new earthen vessel will 
answer for this purpose,) then add the spirit. Dose from 
ten to twenty drops, two or three times a day. It is best 
taken in a little mild mucilage. 

Mustard. 

The whole seeds of mustard, taken in doses of from 
one to six tea spoonfuls, in molasses or jelly, is a useful 
stimulant alterative in rheumatism, gouty cramps, and 
other diseases. 

Myrrh. 

The character of myrrh is somewhat doubtful; but 
combined with assafcetida and iron, it is a mild and use- 
ful stimulant alterative. The tincture of myrrh has long 
been celebrated as an useful remedy in old sores, and par- 
ticularly where we wish to remove caries of the bone. It, 
doubtless, is a good application to old languid sores; but 
for affections of the bones, the surgeon can remove the 
bone better by means of a cutting instrument. The dose 
of myrrh, as an alterative, is from ten to thirty or forty 
grains. This medicine is proper in all cases where iron 
is indicated. 

Balsam Copaiba. 

This balsam is a warm but mild alterative. It has 
been found particularly useful in cases of gleet and fluor 
albus; and may be given with good prospect in all cases 
of debility of the uterine organs. Dose from one to two 
tea spoonfuls twice a day, taken on sugar. 
Poke, or Garget. 

Poke berries, fully ripe, infused in whiskey or rum^ 
and taken in doses of from half to two table spoonfuls, 
has been found useful in cases of rheumatism; and, ac= 
cording to some accounts, in scrofula also* 



Mezereon Hoot, 
Sassafras Bark, 
Seneka Snakeroot, 



These are all stimulant al- 
teratives, & are used in de- 
coctions, called diet drinks. 



Prickly Ash Bark, J>They may be used sepa- 

Pine, the chips of knots, j rately, or conjoined: they 

Sarsaparilla Root, | may be considered more or 

Burdock Root, J less stimulant as they are 

placed in this list, the mezereon being most stimulant, 

and the burdock least so. They will all bear boiling: to 

64 



506 DIFFUSIBLE STIMULANTS. 

advantage, except the sassafras, which should merely 
be scalded. From two drams to an ounce, of two or 
three of those articles, may be boiled in a quart of water 
to a pint, and a wine glassful taken twice a day, in all 
cases where alteratives are indicated; but particularly 
in venereal cases, foulness of the skin; and in all habits 
much subject to biles or ulcers, or obstinate sores. 
They add much to the efficacy of mercury in all chro- 
nicle affections. 

Wine. 
Good old wine is certainly alterative: but as it evi- 
dently belongs to the class of stimulants, it will be ob- 
vious that it can only be salutary for those wanting a 
proper tone of fibre. And experience warrants the de- 
claration, that like all other stimulants it must be pro- 
portioned to the condition or diathesis present. Those 
uuaccustomed to wine will probably derive much benefit 
from the use of it, in most diseases accompanied with 
chronick debility; but in all febrile diseases, and in per- 
sons of plethorick habits, it may prove highly detrimen- 
tal. Upon the whole, this article can only be used with 
good prospect of success, by a cautious regulation as to 
quantity, even where it is a proper remedy. It may not 
be amiss to remark, that wine is always more or less nu- 
trient, where it is judiciously used, 

SECTION IX. 

Diffusible Stimulants. 

Diffusible stimulants are articles which act suddenly, 
and transiently on the living body. Where the sys- 
tem is deprived of its proper energies, by reason of lan- 
guor or exhaustion, these are calculated to excite new or 
increased action. But where they are administered in 
plethorick or inilammatory states of the body, or when 
given largely, under all circumstances, by raising undue 
excitement, they produce indirect debility, which, if long 
continued, terminates in exhaustion, disease, or death. 
80 that diffusible stimulants are only useful in general. 
in what are culled nervous diseases; and even here we 



DIFFUSIBLE STIMULANTS. 50/ 

ought to view them as palliatives. It follows, that in 
the administration of diffusible stimulants, we are to 
place our hopes of permanent relief, on mild nutrients, 
tonicks, exercise, cleanliness, and wholesome air. Dif- 
fusible stimulants, though invaluable, and speedy reme- 
dies, require much caution in their use; for if they exceed 
the proper dose, instead of imparting agreeable feelings^ 
and a more healthy excitement; or, instead of rendering 
excitement more equal throughout the system, they will 
render it still more unequal; or, by interrupting the func- 
tions of the brainular system, they increase the disease, 
and tend powerfully towards death. And of all reme- 
dies, diffusible stimulants most speedily, and certainly 
create a habit which calls for repetition; and a still 
greater evil is that they soon cease to operate, with the 
same force, without a constant increase of the quantity. 
Upon the whole, to be useful or even safe, diffusible 
stimulants must be reserved for emergencies, and should 
ever be viewed as resembling the sudden and sparkling 
sallies of wit: for, like it they amuse us for a time, and 
withdrawing as suddenly as they appeared in both cases, 
a langour is left proportionate to the elevation. Whv g 
durable stimulants, or tonicks, and mild nutrients, r ^ c " 
like the slow, solemn, constant operations of the " jU( jo.. 
ment, cany along the subject with that equinece? iS ' jty of 
force, which is likely to secure the wonted vi gour of 
mind and body. 

Ether. 
Ether (sulphurick, or vitriolick) is a value Jble medi- 
cine. Dose from twenty to sixty drops, and must always 
be taken in cold water. Much depends on keepi^c your 
ether well stopped; it should be stopped with rcea?care 
and kept in the coldest place you can get. 

Compound Spirit of Lavender. 
Oil of lavender, three drains,! Put t\ ie oi]s into th 
Oil of rosemary, one dram, spirit of wine, let it in- 
One nutmeg, grated, Uusetwenty-fourhours, 
Oi cinnamon, thirty drops, f observing to shake i 
Oil cloves, twenty drops, now and then. After- 
Spirit of wine four ounces, j wards fill up a common 
black bottle with proof spirits, or in other words, add 



508 DIFFUSIBLE STIMULANTS. 

three half pints of best whiskey, or rum. Dose from 
twenty drops to two or three te?, spoonfuls on sugar. 
Tincture Cantharides. 

Cantharides pounded, one dram, > Digest seven days, 

Good whiskey or rum, one pint. 5 and then strain 
carefully through paper, (this must never be omitted.) 
Dose from ten drops to twenty; but in tetanus, from one 
to three tea spoonfuls. 

Spirit of Turpentine, 

Turpentine is seldom used in practice, but in palsy, 
or in cases of severe chronick rheumatism, and in gout 
of the lowest grade, in cases of general debility, accom- 
panied with gleet, fluor albus, &c. this article may be 
given to advantage; it may also be used with good effect 
in some protracted cases of ague, taken just before the 
chill. But it must always be recollected that turpentine 
is a powerful stimulant, and must never be given until 
we are well satisfied nothing like plethora, or an inflam- 
matory diathesis exists. Dose from twenty drops to 
sixty, taken on sugar, or beat up with a little raw egg. 
Essence of Feppermint* 

Essence of peppermint is a safe and valuable medi- 
£ue in cases of flatulence, and pain in the stomach and 
Novels, arising from debility or want of tone. Dose 
from five to twenty five drops on sugar. 
Tincture of Jlssafoztida. 

Tincture of assafcetida is a useful medicine in nervous 
diseases, but unless the case is attended with very con- 
siderable direct debility, we cannot expect much effect 
from it; the usual doses containing so little assafcetida 
that the spirits wine becomes the principal. Dose from 
twenty drops to sixty on sugar, or in water. 
Oil of Amber. 

Oil of amber is a powerful stimulant, and a valuable 
medicine, whe*e we wish to stimulate powerfully. Dose 
from three to ten drops, taken on sugar, or administered 
in glysters. 

SjArit of Hartshorn. 
Spirit of hartshorn hi doses of from five to twenty-five 
drops; in cool water, is a safe and useful diffusible sti- 
mulant, but its effects are very transient. 



DIFFUSIBLE STIMULANTS. 509 

Garlick. 
Garlick is most easily taken cut in small slices, or the 
juice may be expressed from the garlick, and mixed 
with a little sweet milk; the sooner it is taken after 
mixing the better- Dose a clove or two, or about a tea 
spoonful of the juice. But if we express the juice of 
garlick, and dry it slowly, it forms an extract so strong- 
ly resembling assafcetida, that it requires some judgment 
to distinguish them; for it smells like assafcetida, is 
whitish within, and when broken open, it soon acquires 
a reddish colour. I am much inclined to believe, this 
inspissated juice would answer every purpose that we 
obtain from the assafcetida. 

Tincture of Bark and Ether. 
Tincture of bark, one ounce 7 Mix: Dose from 

Ether, two or three tea spoonfuls. 3 one to three tea 
spoonfuls. This is a valuable palliative in all habitual 
cases of debility of the stomach. 

Tincture of Bark. 

Bark, one ounce, ? Digest one week, 

Good whiskey or rum, one pint. 5 and then strain. 

Dose from two to six tea spoonfuls. This medicine is 

seldom necessary; where bark is necessary, it is best 

given in any other form. 

Laudanum* 
Laudanum is a valuable diffusible stimulant in many 
nervous diseases as hystericks, low fevers, &c. Dose 
from ten to sixty drops, repeated twice or oftener per 
day. For the preparation of this medicine, see antis- 
pasmodic!^. 

Stramonium, or James Town Weed. 
Stramonium, according to Dr. Barton, is a valuable 
medicine in maniacal cases, and in epilepsy. (The 
leaves or seed ground to a line powder.) Dose, commence 
with two or three grains, and cautiously increase the 
quantity to thirty or tbrty grains. 
Electricity. 
Electricity has been used for a long time, but, if I 
mistake not, it was falling into disuse till it was revived 
by the discovery of Galvani. Since the experiments of 
Volta, and others of France, electricity has been revived, 



510 DURABLE STIMULANTS, Oil TONICKS. 

and used much in the form of galvanism, as well as in the 
common way. I have tried both forms in many cases of 
palsy, rheumatism, &c. and I can with truth declare, I 
never saw any marked benefit from it. And, notwith- 
standing the general recommendation of this remedy, I 
am persuaded a faithful report would convince us, that 
little benefit follows the use of it. I am inclined to be- 
lieve that, its efficacy is principally owing to our over- 
looking the nature of it. It is a diffusible stimulant, and 
like remedies of this class is but a palliative, and always 
transient in its effects. If electricity ever becomes ex- 
tensively useful, it must be accompanied with durable 
tonicks, as well as exercise, and particular attention to 
all the usual means for invigorating the body. I suspect 
chalybeates will mostly be found useful where electricity 
is likely to be beneficial. To conclude, it is probable 
that by using electricity as a diffusible stimulant only, 
we will derive some advantage from it. An interesting 
case of a diseased liver is mentioned, I think, by Darwin, 
in which this remedy was of singular service; but, al- 
though I have used this remedy in many cases, in which 
it is usually thought proper, I have never seen any well 
marked benefit from it. 

Camphorated Spirits. 
Camphor, half an ounce, } Dissolve the camphor 

Good whiskey or rum, a pint. 5 in the spirit, and keep 
it closely stopped. This answers well as a stimu- 
lant, in some hysterical cases, and in very low fevers. 
Dose, from one to three tea spoonfuls; but this medicine 
is used mostly outwardly in strains, &c. 

section x. 
Durable Stimulants, or Tonicks. 

Incalculable advantages are derived from the use of 
tonicks; of this important truth, we have the most ample 
evidence from the experience of every writer, and also, 
in the practice of every day. But notwithstanding the 
most positive conviction of their utility, when skilfully 
applied, still there is proof, equally strong, of pernicious 



DURABLE STIMULANTS, OR TONICKS. 511 

consequences following their use, in unsuitable conditions 
of the body. And, although I have to acknowledge my 
inability to explain their mode of operation, there is no 
doubt on the mind of those skilled in medicine, but that 
they are only useful, or even safe, in cases of direct de- 
bility: that is, where there is langour or weakness, unat- 
tended by fever or general inflammation. 

This important truth has been longer overlooked in 
cases of mortification, than in any other case; and even 
to the present day, physicians of respectability are found, 
who view the bark as a kind of specifick in cases of mor- 
tification; whereas, in gangrene or insipient mortifica- 
tion, nothing could be more injurious than so powerful a 
touick and stimulant, where there was a great excess of 
excitement or action in the part inflamed; but after the 
inflammation is brought down, the bark becomes indis- 
pensably necessary. 

It is probable, all tonicks operate principally on the 
stomach, and by giving tone or vigour to that important 
organ, exert a friendly influence over the general sys- 
tem; both by an improvement in the process of diges- 
tion, and also by an immediate operation upon the ner- 
vous system. 

But to conclude: tonicks or durable stimulants, to be 
useful, must only be taken when the body is enfeebled, 
without fever, or without an active state of the bloodves- 
sels. Iu a great majority of our diseases, we must re- 
duce the patient by evacuants of some kind, before they 
will bear tonicks. Persons subject to habitual diseases, 
mostly require mild tonicks, in the intervals of their dis- 
ease, but during its paroxysm, they mostly require mild 
evacuants, or diffusible stimulants. 
Peruvian Bark. 

This valuable medicine has been brought to us in 
great variety, and I really feel some doubts, after much 
reflection, in giving an opinion. I believe, in general, the 
yellow that is well ground will be found to answer, and 
for the present, that which is put up by Dr. Sanford, is 
the best. 

Many persons in the country, entertain strong preju- 
dices against the bark, from a belief that it will stick in 



512 DURABLE STIMULANTS, OR TONICKS. 

the bones; nothing can be more ridiculous, for there is no 
likelihood of its even getting into the circulation; the 
truth is, that this medicine is a powerful tonick, and 
therefore if given in an inflammatory state of the system, 
like all other stimulants, it will aggravate the disease, 
and by the consequent excessive action, congestions are 
formed, which leave obstinate, or incurable rheumatick 
affections; but this is not the fault of the medicine, but 
proceeds from the abuse of it; and the same consequences 
would often follow the use of animal food or any other 
stimulant, when the body is labouring under an inflam- 
matory diathesis. Dose, from a tea spoonful to a table 
spoonful taken in wine, snakeroot tea, milk, water, &c. 
according to circumstances; where it is used in small 
quantities, simply as a tonick, it is conjoined to small do- 
ses of the elixir of vitriol, to great advantage. 
Dogwood Bark. 

This is a valuable tonick, and may be substituted in 
many cases for the bark. It is sometimes recommended 
in strong decoction, but I have seldom found persons wil- 
ling or able to take it in this way; it generally nauseates 
the stomach: but if the bark is carefully dried, and then 
pounded and sifted through a very fine piece of gauze, or 
a piece of bolting cloth, it answers (particularly when 
mixed with a little bark) every purpose which we can ex- 
pect from the bark alone. Dose, from one to three or four 
tea spoonfuls. 

Elixir Vitriol. 

Elixir vitriol is a mild and invaluable tonick, and has 
been long used for indigestion, debilitating sweats, &c. — 
Dose, from five to thirty drops, diluted with two or three 
table spoonfuls of cool water, or it may be combined with 
bitter cold infusions, such as chamomile, bark, centaury, 
&c. It is prepared thus: 

(rood Whiskey or rum, one pint, 1 j* , 

Sulphurick Acid, or oil. Vitriol, three ounces. 3 " 
the acid slowly into the spirits, digest in a glass vessel a 
few hours, then add of cinnamon and ginger, powdered, 
each half an ounce; digest again for a few days, and then 
suffer the grounds to subside to the bottom, and pour off 
the clear liquor. 



DURABLE STIMULANTS, OR TONICKS. 513 

Black Oak Bark. 
This article was warmly recommended by Dr. Rous- 
seau, of Philadelphia, a few years since. I have used 
it with evident advantage in several cases of intermit- 
tent s. Its efficacy depends much on the fineness of the 
powder. Dose from one to four tea spoonfuls, or even 
more. 

Nitride Acid. 
Nitrick acid is a valuable tonick in scurvy, syphilis, 
and in the convalescence of most fevers; it must be di- 
luted in a good deal of water. Dose from ten to forty 
drops. 

Extract of Bark. 
Extract of bark is sometimes used instead of powder- 
ed bark, and has some advantage in the smallness of the 
dose; as a mild tonick, it will perhaps answer; but in in- 
termittents and mortifications, the bark in substance can 
alone be trusted. Dose from five to thirty grains, in form 
of pills. 

Powder of Bark. 
Bark, two ounces, } Grind the cloves well 

Cremor Tartar, half an ounce, v with the cremor tar- 
Thirty Cloves. ) tar, and mix the whole 
well together. This powder will often lay on the sto- 
mach where bark alone will not. Dose from two to six 
tea spoonfuls. 

Wild Cherry Bark. 
The bark of the wild cherry tree dried, and rendered 
perfectly fine, is a pleasant and useful tonick in cases of 
consumption, &c; and in all cases where tonicks are ne- 
cessary for a length of time, this will be found a pleasant 
and useful change. 



Quassia Wood, 
Gentian Root, 
Columbo Root, 



These are all mild and va- 
luable tonicks; and in cases 
of simple debility, they will 



Chamomile Flowers, 'generally answer our wish 



Carduus, the herb, 
Orange Peel, Centaury. 



es. lu general they are best 
in the form of cold infusion, 



but the extract, or wine bitters made of them, are also va- 
luable articles. 
65 



51<h DURABLE STIMULANTS, OR TONICKS. 

Iron Filings and Must 
These are both valuable tonicks where we wish to 
continue such medicines for a length of time. They are 
more particularly useful in hypochondriacal and hysteri- 
cal cases, and in a languid state of the uterine vessel. 
Dose from five to twenty grains, two or three times a 
day. The following pills will be found a good formula: 
Iron filings or rust two drams, myrrh, or assafcetida, one 
dram: make sixty-four pills, by adding a sufficiency of 
crumb of bread. 

Physicians are found who still carelessly talk about 
steel, when they mean iron. This may lead to errour; 
for it is well known the softest iron is the best tonick 
this metal affords. 

To have it pure, is a matter of vast importance; and 
can only be obtained by filing a soft piece of iron for the 
purpose; that from work shops is never to be trusted, as 
it always contains brass, or other metals. 
White Oxyd of Bismuth. 

White oxyd of bismuth, perfectly white and pure, is 
a valuable tonick in cases of dyspepsia. But for persons 
habitually dyspeptick, this article should only be used 
as a palliative occasionally; for it soon loses its power. 
Dose from two to ten grains, two or three times a day, in 
form of pills. 

Flowers of Zink. 

The flowers of zink have sometimes been found useful 
in epilepsy, and in other spasm odick diseases. Dose 
from one to seven grains twice a day, in form of pills. 
Cuprum Ammoniacum. 

The ammoniated copper has been recommended by 
Cullen and others, in cases of epilepsy. Dose from 
half a grain to three or four grains. This article is not 
much used in the present practice, but it may, with pro- 
priety, be alterated with other tonicks in cases of epilepsy. 
Foiclers Solution. 

This is a preparation of arsenick, but may be used 
with safety in cases of agues, or in a languid state of the 
body, provided we are certain nothing like plethora or 
inflammation is present. It forms the base of, perhaps, 
all ague drops. Dose from five to twenty drops, but it 



ASTRINGENTS, OR ANTIHEMORRHAGICKS. 515 

should never be continued long; and in general, I would 
advise people not to use it without advice. 

SECTION XI. SUBSECTION 1. 

Astringents, or Antihemorrhagicks. 

Some men of eminence doubt whether any articles 
operate on the living body as astringents, and are for 
placing all the articles usually called astringents as com- 
mon tonicks. It is probable no article can operate on 
the living fibre so as to produce constriction, or that kind 
of solidification which we see in the process of tanning 
leather; and further, it must be admitted that all astrin- 
gents, or, in other words, all the articles which have 
been considered as astringents, are tonicks. 

But we are equally certain that tonicks differ much in 
their operation on the living body; and whatever may 
be their mode of operation, some do certainly restrain 
hemorrhage, sweating, and fluxes, from the bowels, &c. 
while others have no such effect. I have, in the pre- 
ceding article, given as my opinion, that it is probable 
tonicks operate on the general economy of the stomach, 
and thereby improve or perfect the digestion of the food, 
and also that they exert an immediate influence upon 
the nerves, and in either, or both ways, they give vigour 
or strength to the system, provided there is a lack of 
stimulus. 

If this opinion be correct, we may, with tolerable cer- 
tainty, conclude that tonicks, which have the property 
of restraining the secretions aud excretions, operate more 
especially upon the nervous system. This conclusion 
derives support from the circumstance, that many of the 
astringents belong to the class of diffusible stimulants, 
which have always been supposed to operate on the 
nerves; and further, that they operate so speedily as to 
answer the intention, particularly in hemorrhages, before 
any additional strength or action is imparted to the ge- 
neral system. Lastly: However unable to explain their 
mode of operation, the practice of every day clearly 
shows that what are considered astringents, will check 



516 ASTRINGENTS, OR ANTIHEMORRHAG1CKS. 

excessive discharges from the body almost instantly in 
some cases, and in others in a gradual manner, but with 
equal certainty; and often too in inflammatory conditions 
of the body. 

It is to be remembered, however, that astringents, 
generally speaking, are but palliatives like diffusible 
stimulants, and, further, that in all cases where plethora 
or an inflammatory diathesis is present, they must only 
be used upon urgent necessity, and always accompanied 
or succeeded by evacuations, and particularly by ab- 
stracting blood: this last remark applies to cases of he- 
morrhages, and, indeed, these are the only cases which 
require absolutely, that we continue the term astringent 
to some tonicks and stimulants; or perhaps, it would be 
well to substitute the term antihemorrhagicks. So 
speedily will astringents sometimes arrest hemorrhage, 
as common salt in bleeding from the lungs; sugar lead 
and opium, uterine hemorrhage, &c. that I think it a 
matter of the highest importance that we continue to view 
some tonicks, and diffusible stimulants, as having pow- 
ers, iu good measure, specifick in checking fluxes of 
blood; and, whether they operate on the living, as the 
most of them are known to act upon dead animal matter, 
(which is extremely doubtful,) is a matter of no conse- 
quence, but to lose sight of their effects, which are as 
evident as the effects of any other remedies, would ma- 
terially injure the practice, and lead to danger, for al- 
though all astringents are either stimulants or tonicks, 
all these are by no means astringents or antihemorrha- 
gicks; and hence, to stickle at viewing some tonicks as 
having a peculiar influence, which is more especially cal- 
culated to check bleedings for a time, till the vessels may 
be emptied in some degree, because we are able to say, 
astringents cannot act on the living as they do on the dead 
animal fibre, is certainly to stickle about trifles, and in 
the face of experience. Let us then, on the safe basis 
of experience, boldly administer our astringents as anti- 
hemorrhagicks in alarming cases of hemorrhages, but 
never forget they are palliatives, and must be assisted or 
followed by remedies suited to the present condition of 
the body. 



ASTRINGENTS, OR ANTIHEMORRHAGICKS. 517 

Common Salt. 

The unquestionable efficacy of this remedy, in check- 
ing hemorrhage from the lungs, has given rise to the li- 
berty I take in proposiug the term antihemorrhagicks, 
for that of astringents, for common salt cannot, strictly 
speaking, be viewed either as an astringent, or tonick, in 
the case before us, according to the common notion of as- 
tringency; but there is every appearauce of this article, 
and several others, as opium and ipecacuanha, having 
antihemorrhagick effects, and therefore, I think it would 
be an improvement in nomenclature to substitute the term 
autihemorrhagicks, in many cases, for that of astrin- 
gents; but as I feel much diffidence in suggesting innova- 
tion in technical language, I have continued the term as- 
tringents, and hope this explanation will excuse me for 
including under this head, things which are certainly an- 
tihemorrhagick, but are not astringent. 

Common table salt is given to arrest bleeding from the 
lungs, with safety and good prospect of success in all ca- 
ses, but must always be followed by suitable remedies 
which are more permanent, but slower in operation; these, 
generally, are bleeding, or nauseating articles, &c; but 
in cases of well marked, direct debility, durable tonicks, 
rest, and mild but nutrient food. Dose from two to ten 
or more tea spoonfuls, taken in a dry state, nor must 
the patient drink immediately afterwards, or its effect 
will be lost. 

Laudanum, and solid Opium. 

Strong opiates are valuable antihemorrhagicks, in 
some cases of uterine hemorrhage, and bleeding from th^ 
bowels; but are only admissible where inflammation has 
not come on, which opiates will often prevent, or after in- 
flammation has in a good measure subsided. Where we 
have doubts about the presence of inflammation, or where 
it has not made its appearance, we should combine a lit- 
tle sal. nitre, or a very little ipecacuanha; the first will 
have a tendency to cool, and the latter, by exciting nau 
sea, will weakeu the force of the heart, and thus accom- 
plish our purpose. Dose of laudanum from ten to six- 
teen drops, of opium from one to three grains. 



518 ASTRINGENTS/ OR RESTRINGENTS. 

Sugar Lead. 

Sugar of lead may be given with safety and advantage 
in hemorrhages from the uterus, from the intestines, or 
from the stomach; but although perfectly safe in the hands 
of the physician, I would advise that it only be used in 
cases of emergency without advice. Dose from one to 
five grains, in form of pills, and I think it should always 
be combined with a fourth, a half, or a whole grain of 
opium, to each dose. And it must be remembered, that 
unless two or three doses answer our wishes, we should 
not repeat oftener, on the same day: three or four pills 
containing each two grains of the lead, and repeated eve- 
ry quarter, half, whole, or two hours, according to the 
urgency of the case, will mostly answer our purpose. 
White Vitriol. 

White vitriol, in doses of two or three grains, combin- 
ed with a fourth, or half a grain of opium, has been found 
a useful antihemorrhagick; where fever is present, it 
must be given so as to excite slight nausea. It is prin- 
cipally useful in hemorrhage from the bowels unattended 
with considerable fever. 

Alum. 

Alum has been much used for restraining hemor- 
rhages in general, but, since the introduction of sugar of 
lead, it has been less used. Where other articles are not 
at hand, it may be used sometimes with considerable ef- 
fect. Dose from ten to twenty grains, repeated every 
half hour, or as the case may require. Alum may be 
used with good effect in agues, where the bark cannot be 
taken; for this purpose, it must be combined with some 
aromatick, as nutmeg, or cinnamon, &c. 

subsection 2. 

Astringents, or Restringents. 

Kestringents are, perhaps, all tonicks; but as all ton- 
icks have no immediate or speedy restringent effect, there 
is an absolute necessity for distinguishing a few of them, 
under the head of restringents. 



ASTRINGENTS, OR RESTR1NGENTS. 519 

The articles placed under this head, are such as are 
known to lessen protluvia, or excessive discharges from 
the body; but being tonick, are never allowable or safe, 
ji here there is plethora, or inflammatory action. Most 
of them have little or no antihemorrhagick effect; those 
that have, are either given in smaller quantities, or at 
longer intervals; they are given principally for affections 
of the first passages. 

Dewberry Root and Leaves, 

A large handful of dewberry root fresh, and cut into 
pieces; or the same quantity of leaves, boiled a few mi- 
nutes in a new earthen pot, with one quart of water, is a 
mild and useful restringent, in cases of diarrhoea, dysen- 
tery, &c. Dose a wine glass every two or three hours. 
Iceland Moss. 

Iceland moss is a valuable and mild restringent, in ca- 
ses of diarrhoea, particularly that attending consumption; 
and on account of its nutrient, mild tonick and restrin- 
gent properties, is an invaluable medicine; and, in my 
opinion, ought to be much more used in all cases of chro- 
nick debility. It may be boiled in water, in the propor- 
tion of an ounce to a quart of water for cases of diarrhoea: 
but where we wish to obtain its nutrient properties, it 
should be boiled in milk; in this form, it is essential that 
we prepare but little at once. In both forms, it may be 
taken in the quantities of a wine glass, occasionally. 

Uva Ursi. 

Uva Ursi, taken in the form of powder, in doses of from 
twenty to sixty grains, two or three times a day, is a 
valuable restringent, more particularly, in debilitating 
discharges from the urinal organs. It may also be given, 
with good effect, in debility of the bowels; and when ta= 
ken in milk, it is slightly nutrient. 
Lime Water. 

Lime water is an useful restringent in cases of protract- 
ed diarrhoea, weakness of the urinal organs, attended 
with stone or gravel. It is made by moistening a well 
burnt piece of lime with a small quantity of water, and 
as soon as the lime is slacked, pour on cold water, which 
jji bulk, would be about ten times greater than the lime, 
stir this well, then suffer the lime to subside, and strain 



5£0 EXTERNAL ASTRINGENTS. 

the clear liquor through common brown paper placed 
over a funnel; afterwards it must be carefully stopped in 
glass bottles, and this must be done immediately, or the 
lime will separate from the water. Dose from two to four 
ounces, frequently repeated, but like the alkalies, it will 
injure the stomach if long continued. 

ICino, (a Gum Resin.) 
Kino, in form of pills, or ground in water, with a lit- 
tle sugar, and one drop of oil of anise to each ounce of 
water, is a valuable restringent where we wish a^speedy 
effect; and even in protracted cases of hemorrhage, it will 
be found a valuable astringent. The dose of kino, ei- 
ther in substance or mixture, is from five to twenty grains, 
twice a clay. Laudanum in small doses is a valuable 
restringent. 



Alum. 

White vitriol, 
Sugar lead. 



These are all safe restrin gents, 
but with the exception of the 
oak bark, they must be given in 



Extract of logwood, very small doses, and may most 



Elixir vitriol. 

All pleasant bitters.^ 



ly be combined with small do- 
ses of laudanum. Or require 
the co-operation of exercise, strict temperance, bathing, 
mild buj nutritious diet. The sugar of lead, though 
perfectly safe, in small doses, as half or a whole grain, 
should never be continued more than a few days. 

subsection 3. 

External Astringents. 

External astringents are remedies applied in form of 
liniments, ointments, or embrocations, with the intention 
of repelling or drying up sores, of various kinds. And it 
must be remembered of these, that like internal astrin- 
gents, they are only safe, where the body is free from any 
considerable fever or plethora. But in many cases, ex- 
ternal astringents may be used before fever has come on, 
and thus arrest local affections before the general system 
is brought into sympathy. And in many slighter cases, 
nothing is to be apprehended from their application to 
weeping surfaces. 



EXTERNAL ASTRINGENTS. 621 

Decoction of Oak Bark. 

The inner bark of oak is to be chipped, and a large 
handful boiled a few minutes in a new earthen pot, with 
about half a gallon of water. This may be used for wash- 
ing old sores, ulcers, protracted cases of burns, and scor- 
butick or scrofulous ulcers; and where there is considera- 
ble debility without fever, a little alum may be added. 
This decoction should be used tepid. 
Lime Water. 

For preparing lime water, see subsection second, of the 
article on astringents. This is a valuable external as- 
tringent in all cases where we wish to dry up weeping 
or running sores. 

Lime Water Liniment* 

Mix equal quantities of lime water, and sweet oil or 
cold drawn flaxseed oil. This is generally viewed ra- 
ther as an emollient, but is certainly slightly astringent, 
and a valuable application in cases of burns, and other 
painful sores. 

Liniment of Lead. 

Sweet oil one ounce, sugar lead half a dram, shake this 
well together. This is a valuable astringent in cases of 
piles, and for other painful sores, it may sometimes be 
applied to inflamed eyes. 

Lead Water. 

Spring water one gill, sugar of lead fifteen grains. 
This is a mild and useful external astringent, and may 
be made a little strouger or weaker, as the case may re- 
quire; it will be obvious that the more lead, the more as- 
tringent the solution. It should never be applied to large 
raw surfaces. 

Borax. 

Borax dissolved in rose water or common water, is a 
valuable external astringent for sore nipples, chaps of the 
lips, &c. It is also a valuable article in mouth water. 
Dissolve half a dram in one gill of cold water. 
Ointment of White Lead. 

Bees-wax one ounce, best hogslard three ounces, melt, 
and while cooling, stir in six drams of the white lead 
ground fine. This ointment is useful in chaps, excoria- 
66 



b%% ANTISPASMODICS. 

tions, &c. and may sometimes be applied to small ulcers 
with advantage. 

Ointment of Calamine. 

Yellow wax two ounces, best lard six ounces, melt, 
and while cooling, stir in two ounces of well ground ca- 
lamine, (or lapis calaminaris.) This has long been used, 
as a mild drying, or astringent ointment; and is similar 
to the celebrated Turner's cerate. It is used by apply- 
ing once a day; and, in general, where it is used, mild 
astringent embrocations or washes, are to be used, as 
lime water, oak bark, &c. but there may be cases where 
the cerate, or ointment, will answer better, by simply 
washing the sore with castile soapsuds. 

Ointment of Armenian Bole. 

Red, or Armenian bole, ground fine, may be added in 
the proportion of half an ounce, to three ounces of lard 
and one ounce of wax, melted, observing to stir the 
whole well together till the ointment becomes stiff. This 
ointment is often useful in old superficial sores; but in 
general, the calamine ointment will answer every purpose 
to which this is applied. 

SECTION XII. 

Antispasmodicks. 

Antispasmodicks, strictly speaking, are remedies which 
are only useful, or even safe, in cases of spasm arising 
from debility; being what is properly called atonick 
spasms; for, where spasm arises in an opposite or pie- 
thorick, or inflammatory state of the system, being what 
has been called tonick spasms, nothing of a stimulant 
quality can be admissible; here bleeding and other evacu- 
ants are the proper, and only antispasmodicks. We are, 
therefore, carefully to examine the case before we admi- 
nister common antispasmodicks, and be satisfied the 
spasm present is of the atonick kind, or dependant on 
direct debility. 

Opium. 

Opium, in the milder spasmodick diseases, as hyster- 
icks, hypochondriasis, &c, is a valuable antispasmodick, 



ANTISPASMODICS. ' 523 

given iii doses of, from an eighth of a grain, to a whole 
grain. But in cases of violent spasmodick colick, in se- 
vere contused wounds, or in tetanus, we should begin 
with doses of, from one to five or six grains. Its effects 
commence generally in a few minutes, and wear off in 
from two to twenty-four hours. It is to be remembered, 
that although opium, in proper doses, is a powerful anti- 
spasmodick, it nevertheless will produce spasms, when 
given in overdoses. 

Laudanum. 

Opium, half an ounce, good whiskey or rum, half a 
pint; cut the opium into small slices, digest about a week, 
and then strain. The same observations apply to lauda- 
num as to the solid opium, with this difference, that the 
liquid will operate more speedily, and sooner lose its ef- 
fects. Dose in mild diseases from ten to thirty drops; in 
violent cases from a tea spoonful to a table spoonful; it is 
in cases of disease from drinking cold water, Dr. Rush 
mentions so large a dose as a table spoonful; it is seldom 
safe to give more than two or three tea spoonfuls. 

Ether. 

Yitriolick ether is a powerful, and speedy, antispas- 
modick, and may be given in doses of, from ten drops to 
two or three tea spoonfuls; more than a tea spoonful is 
not often necessary. It must always be taken in cold 
water, and may be combined with laudanum to advan- 
tage. Ether must always be well stopped, and it will 
generally be best to pour the quantity wanted, as near as 
we can guess, at once into a tea spoon, for, if we suffer 
it to drop, it will evaporate and lose its properties. It 
may be well to remember, that if it is dropped near a 
candle it may take fire, and this getting into the vial, has, 
sometimes produced great alarm, and is not without dan- 
ger to the by-standers. 

Compound Spirit of Lavender. 

For the preparation of compound spirit of lavender, 
see the section on diffusible stimulants. This is an use- 
ful antispasmodick, in low nervous diseases; but is a 
powerful stimulant Dose from twenty drops to one or 
two tea spoonfuls. 



¥£& ANTISPASMODICS. 

Assafoetida, 

Assafoetida, in form of pills, is a valuable antispas- 
niodick, and lias the advantage of opening the bowels 
slightly. Dose from five to twenty grains. 
Tincture of Assafoetida. 

Assafoetida six drams, good whiskey or rum, half a 
pint, digest about a week, and strain; this is given in do- 
ses of, from ten to fifty drops, in cases of hysterical, or 
other mild spasrnodick diseases. 

Antispasmodick Glyster. 

Dissolve one or two drams of assafcetida, in the usual 
quantity of water, and administer it as a glyster; this will 
sometimes be found a valuable article for persons affect- 
ed with asthma, hystericks, &c. and for those wlio can- 
not take assafoetida in any other form. 

Garlick. 

A clove or two of garlick sliced, and taken raw; or 
the expressed juice inspissated, and made into pills, is 
a valuable antispasmodick, in cases of hystericks, hypo- 
chondriasis and asthma, more particularly, when these 
diseases are of long standing, or in reduced habits. The 
dose of the inspissated juice may be from five to twenty 
grains. 

Whole Mustard Seed. 

Whole mustard taken in doses of, from half to a whole 
table spoonful, in molasses or thin jelly, is a valuable 
antispasmodick, in cases of habitual or gouty cramps in 
the limbs. 

Rue, the Juice. 

Rue juice, expressed from the fresh plant, and taken 
in doses of, from one to two tea spoonfuls, in milk, or a 
little mucilage, is a good antispasmodick, in hysterical 
cases, and in cases of spasmodick affections of the lungs. 

Wine. 

Good old madeira, sherry, or lisbon wine, sweetened 
in water, or made into whey with milk, is an excellent 
antispasmodick, in all cases of spasms of the atonick 
kind. But, in general, other articles are to be prefer- 
red, lest the wine lead to a bad practice of taking too 
much. 



CARMINATIVE STIMULANTS. 525 

Oil of •Amber. 

Oil of amber is a useful antispasmodick, in cases of 
tetanus, and in the comatose state of low fevers. Dose 
from three to ten drops on sugar. This article may also 
be used in injections, from fifteen to twenty-five drops, 
may be added to a common glyster. 
Balsam Peru. 

Balsam Peru in doses of from twenty to thirty drops, 
on sugar, is a useful antispasmodick, in cases of lead co- 
lick. It may be combined with castor oil. 
Sweet Spirit of Nitre. 

Spirit of nitre, in doses of from one to three tea spoon- 
fuls, is a pleasant and valuable antispasmodick, in al- 
most every variety of spasm. It must always be taken 
in cold water. 

Valerian, (Sylvestr is or wild.) 

Valerian, in form of powder, or in tea, is a valuable 
and mild antispasmodick, in hystericks, and in low fe 
vers, St. Vitus' dance, epilepsy, &c. Dose in powder, 
from twenty to forty grains, in tea; half a pint of boiling 
water may be added to two drams of valerian. The tea 
must not be suffered to boil, it must be closely covered, 
and never suffered to stand long. 
Sugar Lead. 

Sugar of lead combined with opium, in form of pills, 
will be found a safe and valuable antispasmodick, in 
some cases of violent asthma. Sugar lead, eight grains, 
opium two grains, with a little crumb of bread, make four 
pills; give one every twenty or thirty minutes. 

SECTION XIII. SUBSECTION 1. 

Carminative Stimulants. 

Carminatives in general, are both diffusible stimulants, 
and antispasmodicks; but nevertheless differ in this, that 
carminatives are given exclusively with a view of expell- 
ing wind from the stomach. They seem to operate by 
imparting a due degree of stimulus to the languid sto- 
mach, by which this viscus is enabled to throw off sharp 
wind, &c. And it is to be remembered of carminatives, 



52Q CARMINATIVE ANTACIDS. 

that they are only admissible where the stomach is in a, 
state of atony, for as they are stimulants of speedy ope- 
ration, much mischief may arise from their use in cases 
of inflammation of the stomach and bowels, and also, in 
cases of disordered stomach attended with fever. 
Essence of Peppermint. 
Essence of peppermint is a valuable carminative, ta 
ken in doses of from five to twenty drops on sugar, or 
made into tea. Or tea may be made of the dried herb. 
Oil of Spear Mint. 
The oil of mint, taken on sugar, or in the form of 
tea, is an excellent carminative. Dose from two to six 
drops. 

Oil of Anise. 
The oil of anise, and of fennel, are good carminatives. 
Dose from one to four drops, on sugar, or mixed with a 
little magnesia. 

Ginger. 
Ginger given in form of strong tea, but, in small doses, 
as two or three table spoonfuls, is a good carminative. 
Spirit of Nitre. 
The sweet spirit of nitre is a very valuable carmina- 
tive, in doses of from ten to thirty drops, in cool water. 

Saffron. 
Tea of English saffron, made weak, is a good carmi- 
native. It is to be taken in small doses. 
Soda Water. 
Soda water, highly charged with fixed air, is an ex- 
cellent carminative. But this is more properly, a car- 
minative antacid. Mild pleasant aromaticks in general. 
are carminative, as cinnamon, nutmeg, &c. 

subsection 2. 

Carminative Antacids. 

Carminative antacids are remedies which exert an im- 
mediate effect upon the stomach. But they operate very 
differently from carminative stimulants; for, instead of any 
immediate stimulant operation upon the economy of the 
stomach, they afford relief by neutralizing acid wind or 



CARMINATIVE ANTACIDS. 52~ 

fluids, and probably also destroy fluids, &c. in the form 
of oxyds, which offend the stomach. And as the chymi- 
cal changes among those articles, when taken into the 
stomach affected with acid, have a refrigerant effect, and 
often form mild neutral salts, which gently move the 
bowels, we may often give carminative antacids, even in 
cases of high fever, with the most happy effects; and in 
those general diseases of a middle grade, attended with 
much sickness at stomach, or pain in the stomach, they 
may be combined with small doses of carminative stimu- 
lants with great advantage. But active inflammation of 
the general system, should ever be a bar to the use of car- 
minative stimulants. 

Soda. 

Sal. soda, or the mineral alkali, is a most invaluable 
antacid. Half a dram may be dissolved in ten table 
spoonfuls of cold water; of this a spoonful may be taken 
occasionally, in violent cases of cholera morbus, every 
few minutes. This is a useful medicine for the griping 
of children; for this purpose, a very small portion of oil 
of anise, or spearmint, may be added. 
Sal. Tartar. 

Salt of tartar may be used in all cases where antacids 
are necessary, but it is much more offensive to the taste; 
and I have long been of opinion that it would sooner in- 
jure the stomach, where it is long continued, than soda. 
One scruple will be found about equal to half a dram of 
the soda. Both these articles may be rendered more pa- 
latable, and often equally useful, by mixing a little lemon 
juice, or pleasant vinegar, to solutions of them, and by 
way of variety, a little sugar may sometimes be added. 
They may also be advantageously combined with essen- 
tial oils, as mint, &c. 

Magnesia. 

Magnesia is less refrigerant than salt of tartar, or soda; 
but as it is calculated to combine with acids in the sto= 
mach, and, by such combination, to form a saline matter, 
which opens the bowels, it is admissible in all cases 
where antacids are proper; hvt it is never useful, unless 
acid be present, which causes it to pass through the bow- 
el* Dose from one to three tea spoonfuls, in water, or 



528 FEBRIFUGES. 

eaten in the dry state. Calcined magnesia, is the strong- 
est antacid. 

Prepared Chalk. 

Prepared chalk is a valuable antacid, particularly for 
children. A few grains may be mixed with water, and 
the smallest possible quantity of oil of anise added, or 
it may be given alone, in cases of colicky affections of 
children. If costiveness attend its use, a little lemon 
juice or vinegar and sugar may be given; and if this does 
not open the bowels, give a purge. 
Lime Water. 

Lime water is a valuable carminative antacid in cases 
of dyspepsia, and many other windy affections of the sto- 
mach and bowels; but it seems more particularly suited 
to persons advanced in life. Dose from a spoonful to 
half a gill occasionally. [See restringents for the me- 
thod of making it.] 

White Oxijd of Bismuth. 

The oxyd of bismuth must be chosen perfectly white. 
It is a most excellent antacid in cases of dyspepsia. 
Dose from two to ten grains twice a day. 
Elixir Vitriol. 

Elixir vitriol is, perhaps, more generally used as an 
antacid than any other medicine. It is more slow in its 
effects than most others, but may be continued longer 
than any one with which I am acquainted. It is a valua- 
ble tonick, while all the articles mentioned in this sec- 
tion are mere palliatives, and ought never to be used for 
any great length of time. Magnesia is somewhat of an 
exception to this remark. 

SECTION XIV. 

Febrifuges. 

Febrifuges are medicines which are supposed to have 
-orae cooling, or rathe* a specifick effect, in cases of fe- 
ver. But it may be remarked in the first place, that 
nothing will have much effect in cases of ardent fever, 
hut such as produce some considerable evacuation, as 
bleeding, purging, vomiting, sweating, &c. And, se 



FEBRIFUGES. 529 

condly, it may be observed, that all remedies which Lave 
been considered febrifuge, are laxatives or diaphoret- 
icks, or diureticks, &c; and as the effects which usually 
follow diaphoreticks are only calculated to remove slight 
febrile diseases, we must always view febrifuges as mild 
auxiliaries to more powerful evacuants. And from care- 
ful observations for several years, I am well satisfied 
but little dependance can be put on any medicine given 
as a febrifuge that does not actually purge, or produce 
some other considerable evacuation. But in fevers of a 
low grade, or in other cases, after the body is somewhat 
reduced, by more active articles, febrifuges are valuable 
medicines. 

Sal Nitre. 

Sal. nitre, or purified saltpetre, has been long and 
generally used as a febrifuge. It may be given in fe- 
vers in general; but if it is given in large doses, it will 
sicken the stomach, and if long continued, will always 
impair digestion. Dose from five to fifteen grains, every 
few hours. 

Tartar Emetick. 

Tartar emetick is a useful febrifuge in cases of com- 
mon inflammatory fevers, as pleurisy, phreuitis, &c. pro- 
vided sufficient evacuations are made by the use of the 
lancet, purges, &c. Dissolve two grains in a pint of 
cool water. Dose one or two table spoonfuls every few 
hours. 

JLntimonial Wine. 

For the preparation of antimonial wine, see the article 
on emeticks. This is a good febrifuge, but is not es- 
sentially different from the mixture of tartar emetick. 
The dose being smaller, and the taste less offensive, 
rentiers it sometimes preferable to the solution. 
Ipecacuanha. 

Ipecacuanha is a valuable febrifuge in cases of fevers, 
&c. where we wish to lessen the action of the pulse. 
But it must be given so as to excite slight nausea. It 
may be combined with small doses of calomel or of sal. 
nitre. Dose from one to five grains. 

f\7 



530 EMMENAGOGUES. 

Cremor Tartar. 

Cremor tartar taken in doses of a tea spoonful or two, 
and repeated pretty often, so as to open the bowels, is a 
mild and useful febrifuge. From half, to an ounce may 
be taken in twenty-four hours, and it may be rendered 
palatable by mixing with sugar. Or a pint of boiling 
water may be poured on two drams of cremor tartar, and 
a little sugar added; of this, let the feverish patient drink 
freely. 

Saline Mixture. 

For the preparation of this saline mixture, see the sub- 
section on refrigerant diureticks. It is a mild and use- 
ful febrifuge in fevers generally. Dose from half to a 
whole table spoonful, repeated every few hours. 
Nitrous Mixture. 

For the preparation of this article, see the subsection 
on cooling diaphoreticks. It is a very pleasant and use- 
ful febrifuge, and admissible in all cases where we wish 
to lessen febrile action. Dose a table spoonful about 
every two or three hours. 

SECTION xv. 
Emmenagogues. 

Emmenagogues are medicines which are supposed to 
have some specifick operation over the menstrual dis- 
charges of women. But while we are compelled to ad- 
mit that some articles do exert such influence, we should 
carefully bear in mind, that all reputed emmenagogues 
are powerful stimulants and therefore can only be given 
with safety where there is strong evidence of langour, or 
debility of the general system, or where periodical dis- 
eases, or chronick inflammation is present, and being of 
the rheumatick kind. In all these cases, emmenagogues, 
judiciously given, may have a good effect upon the fe- 
male constitution, where the menses are absent. 
Calomel and Aloes. 

Calomel half a dram, aloes one scruple; rub the aloes 
fine, and make sixteen pills, adding a little crumb of 
bread. One of these may be taken every other evening 



LITHONTRIPTICKS. 531 

in chlorotick cases, or in cases of obstructed menses ge- 
nerally. If they purge much, an anodyne may be given 
on the evenings no pill is taken. 

Tincture of Guaiacum. 

For the preparation of this tincture, see subsection on 
stimulant alteratives. Dose from one to three tea spoon- 
fuls. This tincture is most beneficial in cases of pain- 
ful menstruation, but may be given with advantage, in all 
cases of obstructed menses, attended with langour or de- 
bilitv of habit. 

Madder, 

Though the efficacy of this article is somewhat doubt- 
ful, it is recommended by the excellent Denman, as an 
emmenagogue. Dose about half a dram. 
Pennyroyal. 

Pennyroyal has been used with advantage as an emme- 
nagogue, and was lately brought into notice by Dr. Wat- 
kins, of Baltimore. It may be used in tea, or from one 
to five drops of the oil. It is a powerful stimulant, and 
only proper for persons free from fever, and only a few 
doses taken at the time the menses are expected. 

Mustard. 

Whole mustard seed may be taken in doses of from 
a half to a whole table spoonful every night going to bed, 
in molasses; and is often a good emmenagogue. 

Iron. 

Iron, the rust or filings, is a most valuable emmena- 
gogue in cases of considerable debility of habit, but as it 
acts on the general system by its tonick properties, I 
must refer the reader to the section on tonicks. 

SECTION XVI. SUBSECTION 1. 

Lithontripticks. 

Lithontripticks are medicines which were long used 
under a belief that they possessed the power of dissolving 
calculi, or stones in the human bladder; and perhaps 
they are still taken by persons under similar expecta- 
tions. The most ample experience however, has proved 
that no medicine has any such power. But there is strong 



53S ANTACID LITHRONTIPTJCKS. 

grounds for believing that those articles which have 
maintained their credit as lithontripticks, are either an- 
tacids or mild tonicks. And it is highly probable, con- 
stitutional debility is almost universally the cause of cal- 
culi, or stones in the bladder. I have elsewhere endea- 
voured to argue that gravelly complaints are often the con- 
sequence of a gouty diathesis. Now although we are not 
able by means of lithontripticks, to dissolve the stone, 
the above view of such cases, teaches us that, as acidity 
in the stomach, &c. is the cause of such stony collections, 
and that this tendency to acidity, arises from debility of 
habit, we have reason to believe, that by giving antacids, 
we can, not only prevent their increase, but further by 
combining tonicks with our antacids, we may wholly re- 
move such tendency from the system, and therefore we 
may justly consider several articles as having lithontrip- 
tick properties. Believing as I do, that it is a matter of 
consequence to have a correct notion of lithontripticks, I 
shall briefly state their nature, as respects gravelly pa- 
tients. Chronick debility disposes to acidity, acidity in 
some habits disposes to gravel, therefore, the indications 
are to obviate such a state of debility, to destroy or re- 
move such acidity as predisposes to stone and gravel, 
and thereby to prevent the future increase of such a com- 
plaint. But experience amply proves that some mild 
tonicks have something like a speciiick effect in calcu- 
lous complaints; not of dissolving concretions, but they 
have a diuretick, or some kind of soothing power. But 
after all, if the above theoretick view be correct, we are 
always to combine the antacid, with tonick lithontrip- 
ticks. All lithontripticks should be combined freely 
with mucilage. 

subsection 2. 

Magnesia. 

Of all antacids magnesia is the best for gravelly pa- 
tients: I have often seen the most marked advantages 
from it, and it may be taken, I think, with the same free- 
dom, as to time, as was allowed by Sydenham for the 



TONICK LITHONTRIPTICKS. 533 

use of steel, which was to use it thirty years, aud then if 
necessary, begin again. If it operates gently upon the 
bowels, it is sure to give great relief, in cases of stone 
aud gravel, that are not advanced beyond remedy. The 
calcined will sometimes be necessary to alternate with 
the common magnesia. Dose from two to six tea spoon- 
fuls, twice a day. 

Castile Soap, 

Castile soap, if genuine, that is, made of fresh olive oil 
and soda, as it ought to be, and not too old, is a most ex- 
cellent lithontriptick, and may be continued for any length 
of time. The soda destroys the acid of the habit, while 
the oil defends the surface of the stomach, from the acri- 
mony of the soda. Dose from one to four drams, taken 
in two or three doses per day. 

Lime Water, 

Lime water carefully made, and strained, is a valuable 
lithontriptick; but if long continued will injure the sto- 
mach. In general, this article should be taken along 
with castile soap; or, I think the best way is to alternate 
the lime water with the other articles, and never use it 
more than a few weeks at a time, and then leave a con- 
siderable interval before it is used again. Dose from half 
a gill to half a pint per day. For the preparation of lime 
water, see the second subsection on astringents. 
Sal Tartar. 

Sal. tartar has sometimes been used as a'lithontriptick, 
but this article can never be given for any considerable 
length of time, without much risk of impairing the tone 
of the stomach. 

subsection 3. 

TJva Ursi. 

Uva ursi is probably, one of the best tonick lithontrip- 
ticks, and may be given in all cases of gravel or stone. 
But I think, we should always combine antacids with the 
uva ursi, or any other tonick lithontriptick. Dose from 
twenty to sixty grains, of the leaves powdered* twice a 
flay, in a little milk. ' 



534 OPHTHALMICUS* 

Haw Coffee. 

Raw coffee has been given with good effect, in cases of 
gravel, &c. and as it has no immediate antacid proper- 
ties, we are warranted in placing it among the tonick 
lithontripticks. Take a large spoonful of green coffee, 
well washed, and boil it for a few minutes, in a quart of 
water; this may be all drank in two days. 
Wild Carrot, {the seed.) 

The wild carrot seeds have been used with good effect, 
in many cases of gravel, and may always be alternated 
with those above. Take an ounce of the seed, and boil 
them in a quart of water, then take the infusion in such 
quantities as to use it all in three days. But it is more 
economical to powder the seeds fine, and take from a half 
to a whole dram, twice a day. The coffee beans may 
also be used more economically, in the form of powder. 
Iron Filings. 

Although iron cannot be said to have any immediate 
lithontriptick properties, still as it is one of the best ton- 
icks, and as gravel is mostly found in debilitated habits, 
the iron is among the best remedies, in such habits for 
the gravel or stone. For this purpose the iron in form of 
filings, or rust, may be combined with antacid, or tonick 
lithontripticks, as the case may require; and from half to 
a dram of the iron per day, may be taken. 

SECTION XVII. 

Ophthalmiclcs. 

Ophthalmicks are remedies applied to the eyes, in ca- 
ses of inflammation, or what is commonly called sore 
eyes. A very great number of articles have been pro- 
posed for this purpose, and from the extreme discor- 
dance of their properties, there is little doubt but more 
mischief has been done the eyes than benefit. It was 
long ago observed, by the illustrious Cheselden, that no 
washes containing powders should be applied to the eyes. 
And as far as my opportunities enable me to judge, this 
opinion is correct, and of vast importance. I have ob- 
served, see inflammation of the eyes, that saline articles 



OPHTHALMICUS. 535 

ought not to be used in active inflammation of the eyes. 
The following ophthalmicks will generally be found to 
answer our wishes. 

Milk and Water. 

Take equal parts by measure, of hot water, and milk 
which has stood a few hours and been once skimmed. 
This should be made in small quantities, and may be 
applied to the eyes in all severe cases, either warm or 
cold: persons who go out should not use it warm, at least 
when the weather is cold. No person who has not made 
sufficient trial, can imagine the benefit which may gene- 
rally be derived from a perseverance in this article; 
But I have seen many persons making a large mixture 
of milk and water, and washing the eyes in the same 
vessel for a day or two, but it should be made every two 
hours in warm weather, and twice a day in winter, and 
but a little of it should be poured out for use at each time 
of using. 

Saffronized Milk. 

Boil a few grains of English saffron a few minutes, in 
equal parts of milk and water. This may by used as 
above directed, for milk and water, but it may be observ- 
ed, that this is a little stimulant, and will be found most 
useful in cases somewhat abated of their inflammation* 
It should always be carefully strained, and never long 
kept. 

Rose Water. 

Rose water is a very mild astringent, and when appli- 
ed at a very early stage of ophthalmick inflammation, 
will often go far to prevent its progress. This article is 
always to be applied cold, and therefore is not proper in 
cases of very high inflammation. 

Lime Water Liniment. 

Best sweet oil, or oil of almonds, and lime water equal 
parts. This may be applied in cases of inflamed eyes, 
with great success, particularly in cases where washes have 
been used ineffectually, or where the eye lids incline to 
stick together. For want of good lime water, about three 
grains of sugar of lead may be dissolved in an ounce of 
oil of almonds, but this is more stimulant, and not as ge- 
nerally successful. 



536 ANODYNES. 

Brandy diluted with water, 

Rose water with a little laudanum, 

Chamomile boiled in milk, and a little laudanum, 

Lead water, 

Weak solutions of white vitriol, are all stimulant 
oplithalmicks, and are often used with advantage before 
inflammation has run high, but more particularly after it 
has assumed the chronick form. They are always dan- 
gerous where there is much pain or acute inflammation. 
It is to be observed of diseases of the eyes, that al- 
though the foregoing articles and many others are often 
highly beneficial, we are never to trust them alone in se- 
vere cases. 

The most prompt use of the lancet; leeches about the 
eyes; blistering about the neck; or even on the eye; ac- 
tive cooling purges; low diet; and shunning the light, are 
often necessary to prevent the loss of sight. 

SECTION XVIII. 

Jlnodynes. 

But few people have any correct notion of anodynes, 
for it is almost universally supposed, that opium is the on- 
ly medicine which promotes sleep, and this it is supposed 
to do by some specilick property, of a soporifick quality. 
But the truth is, that opium in every form, is a powerful 
diffusible stimulant, and therefore, unless the system is 
suitably languid, or reduced, or at least free from inflam- 
matory action or fever, opium instead of promoting or 
producing sleep, distracts the brain, and often produces 
delirium or total inability to sleep. So that in all dis- 
eases where there is considerable fever or fulness of ha- 
bit, things quite opposite in their nature from opium, be- 
come anodyne, while opium will raise the fever, &c. and 
have quite an opposite effect. Here a bleeding, a purge, 
an emetick, or cooling drinks, accommodated to the case, 
will induce sleep, by lowering febrile action. 

Let it be remembered then, that all remedies which are 
reputed anodynes are stimulants, and are only admissible 
where there is no acute inflammation. And further, opium 



ANODYNES. 537 

being a stimulant, and as was long since observed by Sy- 
denham, a cordial also, we are by no means to view it as 
a mere soporifick; on the contrary, in all low fevers, in 
many cases of chronick inflammation, in recent wounds, 
in all painful diseases, and even in cases of delirium at- 
tending low fevers, opium becomes a most invaluable sti- 
mulant or cordial, and can be given with great benefit at 
all times in the day. 

The common but erroneous practice of giving opium at 
bed time only, originated at a time when the properties 
of opium were not understood; and the physician who is 
not aware of the vast benefit which may be derived from 
the cordial, or stimulant properties of it, by a proper 
adaption of it to a reduced or irritable state of the sys- 
tem, is deprived of one of the greatest sources of pleasure 
and convenience to himself, and of incalculable advan- 
tages to his patients. 

Opium, 

The dose of pure opium is from one fourth of a grain 
to three or more, in very violent cases; but the most usual 
is about one grain, as a full anodyne. But I strongly sus- 
pect we never meet with pure opium in the shops. 

The Eastern people who prepare this article, adulter- 
ate it shamefully with an extract of the poppy, and in con- 
sequence of this adulteration the dose ought, in general, 
to be larger than is usually recommended; for it is a fact, 
that where opium is given to stimulate the languid sys- 
tem to the sleeping point, and it falls short of that stimu- 
lus which is necessary, it will interrupt sleep, instead of 
inducing it. The best way is to try small doses first, and 
gradually increase them; but I have no hesitation in say- 
ing, after careful observation, that in consequence of the 
reduced quality of opium, our anodynes are generally too 
small. 

He who is able to distinguish the proper state of the 
body, and the times for administering opiates, may ob- 
tain vast advantages from it, and may use it with a free- 
dom which is not often practised; but if it is given in a 
wrong state of the body, or at an improper time, as in the 
paroxysm of a remitting or intermitting fever, &c. conse- 
quences the most dreadful may follow, and tlm mischief, 
68 



538 ANODYNES. 

in all cases where it is wrongly applied, will be in pro- 
portion to the quantity given. It will be advisable, in all 
cases, when commencing with new parcels of opium or 
laudanum, to begin with small doses, lest a material dif- 
ference in the quality may do injury. 

Laudanum. 

For the preparation of laudanum, see the section on 
antispasmodicks. This being a mere solution of opium, 
we are to expect the same effects from it as from solid 
opium, and the same observations, as to its nature and 
use, apply. I may remark, however, that its effects are 
more immediate; and the whole quantity coming into con- 
tact with the stomach at once, produce greater, but more 
transient effects. It seems to follow that smaller do- 
ses of laudanum must be given, and more frequently re- 
peated. 

There is no doubt on my mind but we use a great deal 
too much laudanum; and I am convinced many persons 
lose the chance which they might have of procuring sleep 
from anodynes, by taking laudanum instead of solid opi- 
um. To conclude, opium, as a diffusible stimulant, or 
antispasmodic^ should always be given in the form of 
liquid laudanum; when it is given as an anodyne, it 
should, almost invariably, be given in the solid form; and 
in most cases of low fever, or acute disease, it should be 
combined with two or three grains of ipecacuanha. The 
universal practice of giving laudanum must certainly have 
arose from a lazy habit, which too many have, of giving 
their medicines in the most convenient form. The mak- 
ing of pills is some trouble; to buy laudanum of the apo- 
thecary, is much easier; but let me admonish every per- 
son, that reason supports me, and experience gives full 
assurance, that opium given as an anodyne must be gi- 
ven in a solid state, or its effects will wear off long be- 
fore morning, and leave the patient in a languid, unplea- 
sant, or dangerous state. If laudanum must be given, 
never omit to repeat the dose about three o'clock in the 
morning, provided no paroxysm of fever be then present, 
which would render it improper. 



VERMIFUGES. 539 

Paregorick. 

Paregorick may be made thus: opium, flowers of 
benzoin, each half a dram; camphor one scruple; oil of 
anise half a dram; good whiskey, or rum, one pint; 
digest ten days, and then strain. The elixir of pare- 
gorick is certainly entitled to the name of an anodyne, 
but is, perhaps, strictly speaking, more properly consi- 
dered a stimulant expectorant. It is a valuable remedy- 
in cases of protracted colds, in asthma at the close of its 
paroxysms, in hooping-cough on the decline, &c. But it 
being a powerful stimulant, it should by no means be 
trifled with, or given to persons labouring under fever. 
Dose from a tea spoonful to three or four. 
Godfrey's Cordial. 

Godfrey's cordial, when properly prepared, is a weak 
solution of opium, salt of tartar, oil fennel, whiskey and 
molasses in water; and is a useful medicine in gripings 
of children unattended with fever, and is often useful in 
dysentery, old colds, declining hooping-cough, &c. But 
nothing can be more prejudicial than the practice, too 
common, of constantly dosing children with stupifying li- 
quids. It should never be given for habitual griping; 
for, by keeping up a constant overstimulus in the brainu- 
lar system, the constitution may be totally ruined. 
The Common Hop. 

The hop, which we use in making beer, is supposed 
to have anodyne properties. It may be used by laying 
a small bag, containing good fresh hops, under the head 
of patients; but it is a remedy which I cannot recom- 
mend from actual experience. 

SECTION XIX. 

Vermifuges. 

Vermifuges are medicines which are given with a view 
of destroying worms, found in the human intestines, and 
particularly to children. But as it is highly probable 
that they are not so often detrimental as has been suppo- 
sed, and as all reputed vermifuges are either powerful 
stimulants or drastick articles, they ought to be given with 



540 VERMIFUGES. 

caution. And let it ever be remembered, that almost all 
the diseases of children are inflammatory; and, therefore, 
even where there is strong evidence of worms, we should 
reduce febrile action by evacuations, before we venture 
to give vermifuges, and then most of the vermifuges can 
be given, not only with a view of destroying worms, but 
as useful stimulants, when the system being reduced re- 
quires this new stimulus. 

Where there is good evidence of worms injuring a 
child, without the presence of fever, common vermifuges 
may be given with safety, but we should never give more 
than two or three doses; and then carry it off with some 
pretty active purge. 

Calomel. 

Calomel may be given to children with perfect safety, 
provided due caution is observed. From five to ten 
grains, mixed with a little sugar, may be given children 
from two to ten years, proportioning the dose according 
to the constitution of the child, and to the age, &c. It 
should be given going to bed, and carried off in the morn- 
ing with a brisk purge; remembering, however, that a lit- 
tle jalap, or castor oil, will answer our wishes, as the 
calomel has a purgative quality. I have seen more bene- 
fit from this medicine than any other vermifuge. 
Oil Wormseed. 

The oil wormseed is a valuable stimulant vermifuge. 
Its stimulant properties render it inadmissible in cases 
attended with fever. This article is to be had of the apo- 
thecaries with suitable directions, for its administration. 
Spigelia, or Pink. 

The worm pink is principally given in the form of 
decoction, but may be given to advantage in the form of 
powder, in doses of from ten grains to half a dram, ac- 
cording to the age of the child. It may be used in de- 
coction; half an ounce may be boiled for some time in a 
pint of water, and the tea sweetened, given in the space 
of two days; when it should be worked off with some 
purgative. This article being a diffusible stimulant, 
and somewhat narcotick, is always dangerous during the 
presence of fever, but when fever has abated, is given 
with much success both as a vermifuge and stimulant. 



MEDICINAL NUTRIENTS. 541 

Common Salt. 
Table salt is favourably spoken of by Dr. Rush, as a 
vermifuge. It may be given in doses of from one to two 
or three scruples, according to the age of the child, in 
the morning fasting; it may be dissolved in a little wa- 
ter, or given dry. 

Wormseed, } These are all stimulants, and therefore 
Rue, > not proper where there is fever, they 

Garlick. 3 are to be boiled in milk, and given 
fasting. 

SECTION xx. 

Medicinal Nutrients. 

These are articles which are calculated to obtund acri- 
mony of the body, whether partial or general, but more 
particularly when seated in the stomach and bowels, 
while they at the same time impart a slight portion of 
nourishment; and this nutrient effect is to be expected of 
them, in all cases where the stomach is in a state to act 
upon them; and, it is highly probable, a state of the sto- 
mach which would not act on those mild nutrients would 
speedily prove destructive. 

Slippery Rim. 

The slippery elm bark powdered fine, and dissolved 
in water, is a mild and agreeable nutriment, and may be 
rendered palatable, if necessary, by seasoning with wine, 
vinegar and sugar, cinnamon and sugar, or lemon juice, 
&c; but where it is given for affections of the skin, it is 
best taken in its simple state, and in this form, it affords 
a valuable drink in fevers, &c. Dissolve one or two 
drams in a pint of cold water; this is an excellent, and 
nourishing drink in dysentery, and if not unpleasant to 
the taste, may be made stronger for such patients. 
Gum Arahick. 

Gum arabick which has been carefully selected, so as 
to be pure and perfectly clean, is a pleasant and nutrient 
article, and beneficial in cases of skin diseases, dysente- 
ries, stone or gravel, and when made thin, is a pleasant 
and useful drink in fevers; it may be rendered savou- 



54& MEDICINAL NUTRIENTS. 

ry by adding a little of some pleasant herb, as balm, 
sage, &c. 

March Mallows. 

Mallows in form of tea is a pleasant and useful nutri- 
ent, in intestinal diseases, and in diseases of the skin. 
It may be used either green or dried. All these nutri- 
ents as well as several pure mucilages, will be found par- 
ticularly useful in consumption, and may be used in eve- 
ry stage of it; and also in gout, or scrofula affecting the 
bladder, the kidneys or the skin. 

Iceland Moss. 

The iceland moss is a useful nutrient, and being slight- 
ly tonick also, renders it particularly beneficial in con- 
sumption and other diseases attended with chronick, or 
general debility. For the method of preparing and us- 
ing it, see the article astringents, or restringents. I am 
strongly inclined to believe this moss would be useful in 
old cases of gravel. 

Sago. 

Though sago has usually been considered simply a 
light article of diet, I have thought proper to place it 
among the mediciuals. All light nourishing articles be- 
come medicinal in some measure, in all cases of chronick 
debility, as well as during the convalescence after acute 
diseases. And from the very general use of this article, 
I have thought necessary to say something respecting its 
preparation, &c. Sago is often mouldy, and is often made 
of potatoes. &c. whereas the pure or genuine sago is the 
pith of a tree. We should endeavour to select that which 
is free from musty taste or smell. Sago should be wash- 
ed first in hot water, then through several cold waters, 
and afterwards boiled till it is a perfect jelly; when re- 
moved from tLe fire, it may be seasoned with wine, vine- 
gar and sugar, cinnamon, ginger, &c. according to the 
taste of the patient. But persons affected with fever, 
should never use it seasoned with wuje, and it should be 
made an invariable rule never to keep it long. 
Toast Water. 

Toast water is a valuable medicinal nutrient, and ge- 
nerally grateful to the stomach. In cases of wounds, 
aud in many acute diseases, this is the best, and should 



MEDICINAL NUTRIENTS. 54$ 

often be the only nourishment allowed. I have general- 
ly seen such a great want of care or knowledge in pre- 
paring this article, that I think it a matter of the highest 
importance to admonish the reader, that although this is 
certainly one of the best medicinal nutrients in acute dis- 
eases, when well prepared, it nevertheless, is sometimes 
rendered even prejudicial by want of care. First, cut 
your bread thin, (which should be one or two days old) 
then toast it slowly, and until it is toasted through and 
through. Secondly, make small quantities and prepare 
it often: it will, however, often be advisable to keep a 
slice or two of the bread toasted, but it should never be 
put into the water till it is wanted. Thirdly, it is a mat- 
ter of vast importance to avoid burning it. Most people 
cut off a piece of crust, and burn it hastily, this renders 
it rancid, rough, and in great measure destroys its nutri- 
ent properties. I consider this of so much importance, 
that I am confident many persons labouring under disea- 
ses of the stomach are lost for want of preparing this 
simple drink, in a proper manner. Where we give it as 
the only nourishment, the patient is to eat the toast, soak- 
ed in the water, in reasonable quantities. 
Wine Whey. 

Wine whey is a valuable medicinal nutrient in all ca- 
ses of direct debility, or where there is no considerable 
fever; see the article on cordial drinks. 

Gruel of Wheat, or Oaten Flour. 

This is a valuable mild nutrient, and may be matle by 
throwing one or more tea spoonfuls of flour into a ves- 
sel, then pour over it without stirring, a pint of boiling 
water; when it has stood a few minutes, stir and strain it 
through an old piece of linen. This may be seasoned 
where it is used as a nutrient, with sugar and vinegar, 
wine, cinnamon, &c. but let it ever be most carefully re- 
membered, that by adding much seasoning we destroy 
the mild nutrient properties of these articles, and there- 
fore, in general, they are to be used as plain as may be. 

All mild diluent drinks are medicinal nutrients, and 
when made quite weak, so as to obviate any risk of sjfci- 
mulating, are of vast importance in cases of fever, &c. 



544 DILUENT DRINKS. 

SECTION XXI. — SUBSECTION 1. 

Diluent Brinks. 

Diluent drinks are such as are proper in all common 
fevers, wounds, or in short, all cases attended with an 
inflammatory diathesis. 

Milk and Water. 

Mix one third sweet milk, which has stood a few^ 

hours, and which has been skimmed once, with two parts 

of boiling water. Let it be taken cold or tepid, as the 

case may require, and never kept more than a few hours. 

Barley Water. 

Pour boiling water on one spoonful of pearl bailey, 
stir well, and afterwards wash through several cold wa- 
ters; then boil in clean water till the barley is entirely 
bursted. Set it in a cool place, and when wanted, stir 
a table spoonful of it well into a pint of water; it must 
now be suffered to stand, and then pour off the thin li- 
quor, or it may be strained through an open old piece of 
linen. Barley water may be used cold or tepid, but must 
always be used fresh. 

Toast Water. 

For the preparation of toast and water, see the section 
on medicinal nutrients. 

Milk Whey. 

Place a pint of milk near the fire till it becomes sour, 
and separates into curd and water; let it remain an hour 
or two, and then pour it into another pint of sweet skim- 
med milk; keep it warm till this second pint is turned; 
afterwards, strain it through a thin rag. This may be 
taken warm, tepid or cold, as may be thought necessary. 
Slippery Elm Water. 

Scrape a table spoonful of slippery elm bark, green 
from the tree, or dissolve two or three tea spoonfuls of 
the dry bark pounded fine, in a pint of boiling water; 
beat it well with a spoon, and then strain. This may 
be taken cold or tepid. 



MILD STIMULANT DRINKS. 549 

Apple Water. 

Roast a pleasant sour apple thoroughly, without burn- 
ing, and mash it in a pint of cold water; this is a grate- 
ful drink where no acidity of the stomach is present. 
Tamarind Water. 

Take a table spoonful of tamarinds, pour over it a pint 
of boiling water; stir it well, and after letting it stand half 
an hour, strain. This is generally taken cool, and most- 
ly requires a little sweetening with sugar or syrup. 
Cremor Tartar Whey. 

Heat a pint of milk which has been once skimmed; 
and stir into it one or two tea spoonfuls of cremor tartar* 
.This may be taken cold or tepid. 
Thin Gruel. 

Put one heaped tea spoonful of flour, first tied up in a 
rag, into a suitable vessel, and pour over it a pint of boil- 
ing water. A very little salt may be added, where ex- 
cessive thirst does not forbid. 

Lemonade. 

Drinks similar to lemonade, may be made by mixing 
a little good vinegar and sugar, or boiled cider, cremor 
tartar, and sugar, fee. and the lemonade itself, by mix- 
ing the juice or salt of lemon with sugar, and mixing with 
a considerable quantity of water. The quantity of these 
may be regulated in some measure according to the taste 
of the patient, but let it be carefully remembered, that 
where this drink is used as a diluent, in cases of fever, fec- 
it must always be very weak. 

March Mallows Tea. 

This article may be made by boiling the mallows a 
few minutes in water. 

Flaxseed tea is made by pouring a pint of boiling wa- 
ter on one or two tea spoonfuls of whele flaxseed, ob- 
serving to wash the seed. 

subsection 2. 
Mild Stimulant Drinks. 

Drinks slightly stimulant, are seldom necessary till Ihe 
force of most of our diseases, is in some measure reduced 
69 



£40 TONICK DRINKS, 

But in most inflammatory diseases, as soon as they are 
somewhat abated, and in those of a low grade, from the 
commencement, they are of vast importance, and often 
become principal remedies. I have seen much mischief 
by using these kinds of drinks, either because they were 
a great deal too strong, or given when the patient was 
affected with inflammatory disease; therefore let it be re- 
membered, that they are never to be given strong; if it 
is necessary to stimulate with drinks, those found under 
the head of cordial drinks will be found better, provided 
due caution is observed in accommodating them to the 
state of debility present. 

Contrayerva, 

Virginian snakeroot, 

Chamomile, 

Valerian, 

Common imported tea, 

Saffron, 

Hysop, 

Sage, 

Balm, 

Ground ivy. All these in form of very weak tea, are 
mild stimulant drinks. 

subsection 3. 
Toniclc Brinks. 

Tonick drinks, like tonicks in every other form, can 
only act as such, where there is a debility or languor of 
the system, which renders their use necessary; when 
taken too freely, or in a too feverish habit of body, they 
will always depress or weaken the body, by stimulating 
unduly. 

Cold infusion of chamomile, 

Carduus tea, 

Centaury tea, 

Bitter teas generally, and cold bitter infusions, of bark, 
&c. &c. 

Porter. 



CORDIAL DRINKS. 547 

Strong beer. These arc all tonick drinks, and in ca- 
ses of health or disease, where they are properly propor- 
tioned to the condition of the stomach, the two latter* 
that is porter and beer, are also slightly nutrient. 

subsection 4. 
Cordial Drinks. 

Cordial drinks like those of the tonick kind, are inad- 
missible unless Ave wish to stimulate; and then it is to be 
remembered, that they are more violent generally, in their 
effects, but more transient than tonick drinks. 
Wine Whey. 

Heat a pint of new milk till it nearly boils, then throw in- 
to it from half to a whole gill of wine, strain. This article 
must not be kept more than twelve or fifteen hours. Wine 
whey is highly nutritious in debilitated habits, but in ca- 
ses of dyspeptick patients, we should give magnesia, or 
the whey is very liable to sour on the stomach. 

Wine, 

Punch, 

Toddy, 

Brandy, 

Coffee. These are all cordial drinks, and often of 
singular service, in cases of low fever, and debility of 
habit. Brandy and wine are always to be largely dilut- 
ed when they are used as drink. They are sometimes 
necessary in their raw or undiluted state, but here we are 
always to view them as medicinal, and relieve the thirst 
of the patient, by the use of drinks more mild; most ge- 
nerally they should be of the tonick class. Let it ever be 
scrupulously observed, that cordial drinks are never pro- 
per for chronick debility, or what may be called habi- 
tual debility of constitution; in all such cases^ mild to- 
nick drinks, alternated with diluents, are most proper. In 
short, cordial drinks are used too much, and do much 
mischief, and it will always be the safest way to use the 
diluent or weak tonick drinks till advice can be obtain- 
ed, and if this is not at hand, we should be well satisfied 
the debility present, is of the direct kind, and clearly 



548 OINTMENTS. 

requiring a powerful stimulus. Where there is any 
thing like an inflammatory diathesis, cordial drinks will 
do immense mischief, nay, will often destroy life, spite of 
all remedies. 

SECTION XXII. 

Ointments. 

Basilicon. 

Hogslard, eight parts; rosin, five parts; bees wax, two 
parts. Melt and strain while hot, taking care to melt it 
over a slow fire. This ointment mixed with a portion of 
spirits of turpentine, is a valuable dressing for burns and 
other languid sores. 

Savin Ointment. 
Basilicon, one ounce; savin leaves ground fine, one 
dram. Mix on a marble slab, or smooth board. For 
want of savin leaves, from ten to twenty drops of oil of 
savin may be mixed with the basilicon. 

Ointment of White Precipitate. 
White precipitate of mercury, one dram; hogslard, one 
ounce; oil lemon, or rosemary, five drops. Rub the pre- 
cipitate fine, and mix. For the itch, and other eruptions 
of a chronick nature. 

Ointment of Red Precipitate. 
Red precipitate of mercury, ground fine, one dram; 
hogslard, one ounce; oil lemon, or rosemary, five drops: 
mix. For the itch or foul sores, or ulcers, &c. 
Ointment of White Hellebore. 
White hellebore, ground fine, one dram; hogslard, one 
ounce: mix. For the itch, &c. 

Ointment of Sulphur. 
Flowers sulphur, two drams; hogslard, one ounce; 
oil lemon, or lavender, a few drops: mix. This is an in- 
fallible cure for the itch. 

Blistering Ointment. 
Wax, mutton suet, rosin, cantharides, equal weights. 
Grind the cantharides fine, and stir it into the other arti- 



DENTIFRICE. — CEPHALICK SNUFF. 549 

cles melted, and beginning to grow cold; stir well till the 
mass becomes stiff*. 

Ointment of Corrosive Sublimate. 
Grind two scruples of corrosive sublimate of mercu- 
ry, very fine, and mix on a slab of marble, or a smooth 
board, with one ounce of lard. It will often be neces- 
sary to increase the quantity of lard for persons of ten- 
der skin. 

Turner's Cerate. 
See the article external astringents. 

Ointment of White Lead. 
See the article external astringents. 

Ointment of Armenian Bole. 
See the subsection on external astringents. 
Simple Ointment, commonly ca ? led Healing Ointment. 
White wax, or best clean beeswax, one ounce; best 
hogslard, three ounces; melt. This ointment may ba 
applied to all fresh cuts, excoriations, &c. 

SECTION XXIII. 

Dentrifice. 

Peruvian bark, in powder, one ounce; common salt, 
half a dram; powdered oris root, a few grains. Dissolve 
the salt in as little water as possible, then pour it over 
the bark, and grind it a few minutes in a mortar; add 
the oris, and spread the powder on paper, till it is per- 
fectly dry. 

SECTION XXIV. 

Cephalic!? Snuff. 

Grind half an ounce of sage, or other pleasant herb; 
and add one dram of white hellebore, in very fine pow- 
der. 



550 MOUTH WATER. POULTICES, 

SECTION XXV. 

Mouth Water, or Gargle. 

Dissolve half a dram of borax in a gill of rose water, 
or spring water. 

Another. 

Take one pint of sage tea, not too strong; add one ta- 
ble spoonful of good vinegar, and a little honey or su- 
gar. If we add a little alum, this makes a useful mouth 
water, in languid sores of the mouth, or for cleansing the 
mouth at the close of fevers. Shumack berries boiled 
in water, and this sweetened a little, is a valuable mouth 
water. 

SECTION XXVI. 

Poultices. 

Poultices are principally used as emollients, for ripen- 
ing bealings, or for promoting the formation of pus in 
wounds or sores, which ought to suppurate. But some- 
times they are used with a view of rendering cold appli- 
cations more permanent; for stimulating the feet in cases 
of fever; and here they are called sinapisms; and they are 
also used in cases of gangrene or mortification, for des- 
troying the gangrenous ferment. Poultices for each of 
those purposes will be found in this section. 
Bread and Milk Poultice. 

Break as much crumb of good wheat bread, one or two 
days old, as will make the milk you use about the con- 
sistence of good mush; stir it constantly while boiling, 
and as soon as the bread is well softened, it may be re- 
moved from the fire; but before we do this, we are to add 
a little more milk, or bread, provided the consistence is 
not such as we wish. The milk should be nearly new, 
and the poultice should never be kept more than* a few 
hours. It is always necessary to renew this poultice eve- 
ry two or three hours, where we wish to promote suppu- 
ration. It must always be sufficiently stiff to prevent its 



POULTICES. 551 

running, and so moist as to remain wet upon the sore till 
it is removed, and it should be greased with a little oil, 
lard or butter, after it is spread on a rag. 
Indian Meal Poultice. 

This poultice is made by simply making mush in the 
usual way, and spreading a little grease over its surface 
before it is applied. The same observations apply to this 
as will be found respecting the bread and milk poultice. 
It is a valuable substitute for the bread and milk, and in 
general will answer equally well. I suspect it is a lit- 
tle more stimulant. 

Onion Poultice. 

Boil an onion very soft, then mash it well in milk or 
water, and thicken it with Indian meal or crumb of bread. 
This poultice is a stimulant, suitable for languid heal- 
ings, and will be more stimulant according to the quan- 
tity of onions it contains. It must be applied warm, and 
often repeated. 

Flaxseed Poultice. 

Boil some flaxseed well in water, then thicken with 
crumb of bread, or Indian meal. This is a valuable 
emollient poultice. A poultice of the white lily roots, or 
of the slippery elm bark, may be prepared in the ne 
manner. And it will be found that a proper application 
of the emollient poultices, which have been described^ 
will answer every purpose which we can reasonably ex~ 
pect from emollients. 

Slippery Elm Poultice. 

Take the green or fresh bark of the slippery elm, and 
scrape it fine into cold water till you have it of a proper 
consistence. Or, pound of the dried bark and steep it in 
cold water or vinegar. This is a valuable article in ca- 
ses of strains, or recent inflammation, where we wish to 
prevent suppuration, and may be applied to the eyes 
with much advantage. 

Bread Poultice. 

Soak crumb of bread in lead water, and after mashing 
it well, apply to strains, or recent inflammation from 
bruises, &c. This may also be prepared with vinegar, 
instead of water. 



55% POULTICES; 

Bran Poultice. 

Mix bran and vinegar in a proportion suited to form 
a poultice, and apply it to strains, &c. All these cold 
poultices are discutients, and therefore only to be appli^ 
«d in recent bruises, strains, or inflammations, which we 
may reasonably expect to scatter. 

Stimulant Poultice, or Sinapism, 

Take one or two table spoonfuls of best flour of mus- 
tard, or well pounded mustard seed; or the same quan- 
tity of grated horseradish, with crumb of bread, or In- 
dian meal moistened with vinegar; make a poultice. This 
is applied to the feet, in cases of low fevers, &c. with 
great advantage; and also to palsied limbs, or for rheu- 
matism in the joints. 

Carrot Poultice 

Grate fresh carrots, and add to it about an equal weight 
of good yeast, mix well together. This is applied cold, 
in cases of gangrene or mortification, and also for cancer. 
Gum Plaster. 

Take of diachylon plaster eight parts; gum ammonia- 
cum, galbanum, yellow wax, each one part; melt toge- 
ther over a slow fire. This plaster has been recom- 
mended in this work for indolent healings, and is often 
useful as a defence, from the weather, in rheumatisms, &c. 



INDEX. 



ABDOMEN, or belly — necessary outward distinc- 
tions, 39. 

Anatomy of the human body, 17- — Recapitulation of, 41. 

Alum — Antihemorrhagick, 518. — Astringent, 520. 

Animal Life — Observations on, 53. 

Angina Pectoris, 324. 

Abscess, Psoas, 406. 

Abscess — See Biles. 

Accidents from swallowing cents, buttons, &c. 396. 
From substances stopped in the windpipe, 397.— From 
fish-hooks, &c. 398. — From extraneous bodies in the 
nose and ears, 399. 

Animals — Poisonous bites of, 411. 

Air, Atmospherical — Observations on, 58. — Great weight 
of, 59. — Remarkable sameness of its chymical proper- 
ties, 59. 

Aliment — Observations on, 62. 

Animal Food — Not to be eaten raw 7 , 63. 

Arteries — Described, 30. 

Anterior Chamber — See eye. 

Aquaous Humour — See eye. 

Arteriotomy — Described, 100. 

Assafcetida — Antispasmodick, 524. 

Ague, 162. 

Apoplexy, 217- 

Appetite, want of, 276. 

Ascarides — See worms. 

Asthma, 320. 

Arsenick, Accidents from— See poisons, 414. 

Antihemorrhagicks, 515. 

Afterpains, 449. 

Aphthae or Thrush, 464. 

Alterative Stimulants, 502. — Alterative Evacuants, 501. 
70 



554 INDEX. 

Apple Water — Diluent Drink, 545. 

Antispasmodicks, 52>2. 

Astringents, 518. 

Aloes — Purgative, 484. 

Antimonial Wine — Emetick, 491. — Febrifuge, 529. 

Ammoniacum — Expectorant, 496. 

Amber, oil of — Diffusible Stimulant, 508. 

Anodynes, 536. 

Bark, a powder of — Tonick, 518. 

Balm, the herb — Cooling Diaphoretick, 495. 

Bark, extract of — Tonick, 513. 

Ball Stool — See fistula in ano, 353. 

Barley Water — Diluent drink, 544. 

Balsam Peru — Expectorant, 496. — Antispasmodic^, 
525. — Tolu — Expectorant, 496. — Copaiba — Stimu- 
lant Diuretick, 498. — Stimulant Alterative, 505. 

Bark, Peruvian — Tonick, 511. 

Beer — Sometimes adulterated with Aloes, 72. 

Biles, 407. 

Bilious Fever, 145. 

Bitters, all Astringents, 520. 

Bleeding — By means of the lancet, &c. 98. — In the jugu- 
lar vein, 99. — In the temporal artery, 100. — By means 
of Leeches, 100. — Sometimes necessary to produce 
fainting thereby, 99. — In the foot, 99. 

Bleeding at the Nose, 253. 

Blood — Circulation of, and subject to some change in 
passing through the lungs, 33. — Its component parts, 
35. 

Bloody Urine, 252. 

Bloodshot Eye — See eye. 

Blood Biles, 410. 

Bones — Anatomy of, SO. — Of the head, wisely contrived 
for the birth, 2i. — Of the elbow, 25. — Fractures of, 
360. 

Borax — External Astringent, 521. 

Brain — Described, 31. 

Bread — Some advice concerning it, 64. 

Bronchia? — Described, 39. 

Bruises, 370. 

Breast — Sealing of, 407. — Swelling and pain of, in preg- 
nant women, 438. 



INDEX, 555 

Burdock — Stimulant Alterative, 505. 

Buttons— Swallowing of, 396. 

Burns and Scalds, 374. 

Butter — Should be eaten sparingly, 64. 

Cancer, 335. 

Carminatives, 525. — Carminative Antiacids, 526. — 

Cartilage — Described, 26. — Become bones slowly till the 
twenty-first year, 27- 

Calomel — Purgative, 484. — Stimulant Alterative, 503. 
Emmenagogue, 530. — Vermifuge, 540. 

Carduus — Tonick, 513. 

Carrot, Wild — Seed of, Lithontriptick, 534. 

Cataract, 297- 

Castile Soap — Lithontriptick, 533. 

Castor Oil — Purgative, 485. 

Cents — Swallowing of, 396. 

Circulation of the Blood, 33. 

Centaury — Tonick, 513. 

Cities — More healthy now than anciently, 61. 

Chilblains and Kibes, 284. 

Chalk, Prepared — Carminative Antacid, 526. 

Children — Introductory remarks on their diseases, 459. 

Cephalick Snuff, 549. 

Child-bed Women— See parturient. 

Chamomile — Stimulant Diaphoretick, 494. — Cooling 
Diaphoretick, 495. — Tonick, 513. 

Chlorosis or Green Sickness, 457. 

Cholera Infantum, or summer disease of children, 466. 

Cholera Morbus, 243. 

Chickenpox, 201. 

Chrystaline Lens — See eye. 

Chrystaline Humour — See eye. 

Churches — Some observations on, 61. 

Clap, 262. 

Clothing — Remarks on, 76. — Children sometimes injur- 
ed by too much, 77. 

Contrayerva — Stimulant Diaphoretick, 494.-— Sudori- 
tick, 493. 

Corrosive Sublimate — Stimulant Alterative, 5Q3. — Blis- 
tering in Ointment, 549. 

Coffee, Raw — Lithontriptick, 534. 



556 INDEX. 

Cold Water — Disease from, 378. 

Columbo— Tonick, 513. 

Convulsions of Children, 465. 

Copperhead — Bite of, 411. 

Cowpox, or Vaccina, 469. 

Corns — Remarks on nature of, 18. — Treatment for, 354. 

Colds, or common Catarrh, 185. 

Consumption, 16?. 

Cordial — Remarks on its nature, 71. 

Cornea — See eye. 

Contagious Diseases — Remarks on, 111 & 164. 

Colick, common, £44. — Lead, £45. — Flatulent, £46. — 
Hysterick, 247- — Epidemick, 249. 

Cremor Tartar — Laxative, 488. — Cooling Diaphoretick, 
495.— Evacuant Alterative, 501. — Febrifuge, 530. 

Croup, 183. 

Crusta Lactea of Children, 473. 

Cramp of the Stomach, £79. 

Cupping — Directions for, 10£. 

Cuprum Ammoniacum — Tonick, 514. 

Dance. St. Vitus's, £££. 

Dewberry Root and Leaves — Astringent, 519 

Deafness, 300. 

Dentrifice, 549. 

Diaphram — Described, £9. 

Diabetes, £36. 

Diarrhoea, £60. 

Diaphoreticks — Stimulant, 493. — Cooling, 494. 

Diet — Simplicity of, recommended, 69. 

Diffusible Stimulants, 506. 

Dinner — Should not be too large, 69. 

Diureticks — Stimulant, 497- — Cooling, 498. 

Disorder from drinking cold water, 378. 

Diseases — Require cautious investigation, 93. — Intro- 
duction to, under the head of Nosology, 103. — Of ex- 
cessive excitement, 105. — Of Abstraction, 106. — Ha- 
bitual, remarks on, 1 13. — Summary of, general obser- 
vations on, 114. — Of women, introductory remarks on, 
416. — Of children, introductory remarks on, 459. 

Dislocation of the Jaw, 356. — Of the Shoulder, 357- — 
Of the Wrist, 358.— Of the Neck, 358. 



INDEX. 557 

Domestick Liquors — Ought to have age, 74. 

Dogwood — Tonick, 512. 

Doses of Medicine — Table of, 482. 

Dover's Powder — Sudorifick, 492. 

Drinks — Observations on, 7 1. — Aged persons require 
cordial drinks, 73. — Tonick, 546. — Cordial, 547- — 
Diluent, 544.— Mild Stimulant, 545. 

Dropsy, 210. 

Drowning, 381. 

Drunkenness, 266. 

Dyspepsia, 828. 

Ears — Stoppage of from insects, &c. 399. 

Earach, 273. 

Emeticks, 490.— Powder, 491. 

Electricity — Diffusible Stimulant, 509. 

Elixir Vitriol — Tonick, 512. — Restringent, 520. — Car- 
minative Antacid, 528. 

Elm, Slippery — Expectorant, 497- — Alterative, 502. — 
Diuretick, 498. — Medicinal Nutrient, 541. — Used in 
drink, 544. 

Elder Blossoms — Cooling Diaphoretick, 495. 

Emmenagogues, 530. 

Endemick Diseases, 111. 

Eneuresis, or habit of wetting the bed, 295. 

Epiglottis — Described, 39. 

Epigastrium — Described, 40. 

Epidemicks — Introduction to, 108. — Treated individu- 
ally, beginning with yellow fever, 118. 

Epilepsy, 341. 

Erysipelas, 198. 

Essence of Peppermint — Carminative Stimulant, 526. 

Ether — Diffusible Stimulant, 507. — Antispasmodic^ 
523. 

Eustachian Tube — Described, 48. 

Expectorants, 495. 

Excitement — Mentioned, 53. 

Excitability — Its properties mentioned, 53. 

Exercise — Remarks on, 78. — Advantages of, 80. — Dis- 
advantages from neglect of, 81. 

Extract of Bark — Tonick, 513. — Of Logwood, Astrin- 
gent. 520. 



558 INDEX. 

Eye — Structure described, 49. — Inflammation of, £74. 
Specks on, £98. — Bloodshot, £99. — Watery or weep- 
ing, £99. 

External Astringents, 520. 

Fasting — Injurious to aged people, 69. 

Fainting, £8£. 

Falling Sickness, 341. 

Fauces — Part of the mouth, 40. 

Fever, Yellow, introductory remarks on, 118. — History 
of, 1£0. — Treatment of commences, 134. — Conclud- 
ing remarks on, 141. 

Febrifuges, 528. 

Fever, Bilious, Remittent, 145. — Typhus, Epidemical, 
148 & 145. — From local causes, £07. 

Fever— Intermittent, 16£.— Scarlet, £00.— Miliary, £03. 
Malignant, from local causes, £04. — Inflammatory, 
£09.— Puerperal, 450. 

Felon, or deep seated inflammation of the finger, 409. 

Fish-Hooks — Accidents from, 398. 

Fistula in ano, 35£. 

Flatulence, or windy bowels, £83. 

Flux, bloody, 157. 

Fluor Albus, 458. 

Fly Poison, 414. 

Focus — See eye, 49. 

Food — Improper to take too much at dinner, 69. 

Fortuitous Diseases — Remarks on, 11£. 

Fowler's Solution — Tonick, 514. 

Fractures of the Bones, 360. 

Frostbites, 376. 

Gamboge — Purgative, 485. 

Gargle— Mouth Water, 550. 

Garlick---Diffusible Stimulant, 509. — xVntispasmodick, 
5£4. — Vermifuge, 541. 

Gall Bladder— Described, 38. 

Ginger — Carminative Stimulant, 5£6. 

Glands — Described, 36. 

Gentian Root — Tonick, 513. 

Glottis— Described, 39. 

Gleet, £64. 



INDEX. 559 

Glysters, 498.— Emollient, 500.— Cooling, 500.— Purg- 
ing, 500. — Stimulant Purging, 500. — Laxative, 500. 
— Anodyne, 501. — Stimulant, 501. — Nutrient, 501. — 
Antispasmodic!*, 524. 

Glauber's Salts — Purgative, 485. — Alterative in Kuhn's 
powders, 502. 

Godfrey's Cordial — Anodyne, 539. 

Gonorrhoea, 262. 

Goitre, 330. 

Gout, Legitimate, 304. — Vibrating, 310. — Illegitimate, 
310. — In the kidneys, 312. — Gonorrheal, 312. — In 
the testes, 313. — In the hip, 313. — In the intestines, 
315. — Different grades of, 314. — General observations 
on, 316. 

Ground Ivy — Cooling Diaphoretick, 495. — Mild Stimu- 
lant, 546. 

Gripings of Children, 46 L 

Gravel, 326. 

Green Sickness — See chlorosis. 

Gruel — Diluent drink, 545. — Nutrient, 543. 

Gutta Serena, 296. 

Gum, red — Disease of children, 463. — Yellow Gum, 
462. 

Gum Arabick — Nutrient, 541. 

Guaiacum — Stimulant Alterative, 504. — Emmenagogue, 
531. 

Habitual Diseases — Remarks on, 113. 

Hsemoptoe, 250. 

Hanging, 384. 

Hemorrhoids, 349. 

Hcematodes — See malignant scrofula, 335. 

Heart — Described, 30. 

Hearing — Organs of, described, 47. 

Headach, 269. 

Heartburn, 277. — Of pregnant women, 436. 

Hernia Humoralis, 263. 

Hernia?, or Ruptures, 372. 

Hemlock, or Cicuta— Stimulant Alterative, 504. 

Herpetick Affections, 286. 

Hemorrhage, or bleeding from the nose, 253. — General 
observations on, 254. 

Heira Picra — Purgative, 486. — Laxative, 48fc 



560 INDEX, 

Hives, or Croup, 183. 

Hickup, 278. 

Hooping- Cough, 154. 

Hops, common — Anodyne, 539. 

Horseradish — Stimulant Diuretick, 497- 

Hypochondrium — Described, 40. 

Hypogastrium — Described, 40. 

Hydrops Pectoris, or Dropsy of the Breast — See dropsy. 

Hydrocephalus, Dropsy of the Head — See dropsy. 

Hydrocele, Dropsy of the Scrotum — See dropsy. 

Hydrophobia, 223. 

Hypochondriasis, 343. 

Hystericks, 347. — Hysterick fits of pregnant women, 
439. 

Iliac Passion, 248. 

Insanity — Remarks on, 237. 

Inflammation — Of the Stomach, 186. — Of the Intestines, 
187.— Of the Kidneys, 188.— Of the Bladder, 189.— 
Of the Diaphram, 190.— Of the Peritoneum, 190.— Of 
the Liver, 191. — Of the Brain, 193. — General obser- 
vations on, 195.— Of the Testes, 263.— Of the Eyes, 
274. — Of the eyes of Infants, 463. — Of the Muscular 
and Glandular parts, 401. — Of the Female Breast, 407. 
Of the Nipples, 408.— Of the finger, called Felon, 409. 
Of the Uterus, 455. 

Influenza, 147- 

Iceland Moss — Nutrient, 542. — Astringent, 519. 

Incubus, 280. 

Injections, or Glysters, 498. 

Introductory remarks on diseases of women, 416. 

Insects — Stings of, 413. 

Infusion of Senna- --Purgative, 488. 

Ipecacuanha— Emetick, 490.— Sudorificl^492.---Stimu- 
lant Diaphoretick, 483.— Alterative, 502.— Febrifuge, 
529. 

Iron— Emmenagogue, 530. ---Filings of — Lithontrip- 
tick, 534.— Filings— Tonick, 514. 

Ischuria, 295. 

Itch, 288. 

James Town Weed, or Stramonium— -Accidents from, 
See poisons. ---Expectorant, 496. --Diffusible Stimu- 
lants, 509. 



INDEX. 561 

Jalap — Purgative, 484. 

Joints — Dislocations of— See dislocations. 

Jaundice, 234. 

Kidneys — Described, 38. 

Kibes and Chilblains, 284. 

Kino — Astringent, 520. 

Lachrymal Duct — See watery eye. 

Lacteals — Described, 37. 

Lacing — Practised by females, highly pernicious, 77. 

Laudanum — Diffusible Stimulant, 509. — Anodyne, 538, 

Antispasmodic!^ 523. — Antihemorrhagick, 517. 
Laxatives, 488.— Pills, 489. 
Leeches — Bleeding with, and how to preserve them 

alive, 100. 
Lemonade — Diluent Drink, 545. 
Leprosy, 291. 
Lime Water — Carminative Antacid, 528.—- Litbontrip- 

tick, 533. — External Astringent, 521. — Astringent, 

519. 
Lientery, 260. 
Ligaments — Described, 27. 
Liquorice Root — Expectorant, 497- 
Liniment of Lime Water — Ophthalmick, 535. 
List of Medicines, in which the properties of each arti- 
cle is carefully pointed out; and this is information 

highly important, 477. 
Liniment of Lead — External Astringent, 521 . 
Liver — Described, 38. 
Lithontripticks, 531. 
Locked Jaw, 219. 

Logwood, extract of — Astringent, 520. 
Longings of Pregnant Women, 437. 
Love — Dangerous without a proper direction of it, 84. 
Lues Venerea, 336. 
Madder — Emmenagogue, 531. 
Madness, 237. 
Magnesia — Laxative, 488. — Carminative Antacid, 527, 

Lithontriptick, 532. 
Mallows, March— Nutrient, 542.— Diluent Drink, 545, 
Malignant Sore Throat, 155. 
Malignant Fever, 204. 
71 



562 



INDEX, 



Manna— Purgative, 486.— Laxative, 490. 
March Mallows— Expectorant, 497.— Coolins; Diapho- 
retic^ 498. 

Materia Medica— Commences with a valuable list of 

medicines, 4/7. 
Measles, 151. 
Medicinal Nutrients, 541. 
Mediastinum — Described, 39. 
Melancholy, Religious — Observations on, 84. 
Menses — Introductory Remarks on, 420. — Appearance 
and Disappearance of, 423.— Painful State of, 424. 
Treatment for the Painful, 427.— Too Sparing Con- 
dition of, 429.— Excessive State of, 430.— Total Re- 
tention of, 431.— Final Cessation of, 432. 
Measures for Liquids, Table of, 483. 
Mesentery — Described, 37. 

Mercury— Stimulant Alterative, 503. — See list of medi- 
cines for the properties of Calomel, Mercurial Oint- 
ment, and Mercury, 477. 
Mezereon — Stimulant Alterative, 505. - 
Milk Whey— Diluent Drink, 544. 
Miliary Fever, 203. 
Milk and Water— Op hthalmick, 535.— Diluent Drink. 

544. 
Milk Crusts of Children, 473. 
Mind — A sketch of its nature, 55. 
Mixture, Nitrous Cooling, 495.— Saline Cooling, 498. 
Morphew, 290. 
Mortification, 403.— In the Mouth, 405.— In the Toes, 

405. 
Mouth— Description of its Parts, 40. 
Mouth Waters, 550. 
Mumps, 203. 

Muscles— Described, 27.— Those within the Body, 29. 
Mustard, the Seed— Antispasmodick, 524. — Emmena- 

gogue, 531. 
Myrrh, 505. — See list of medicines. 
Nerves — Described, 32. 

Night Air— Should not interfere with ventilation, 60. 
Nightshade — Accidents from — See poisons. 
Nitrous Mixture — Febrifuge, 530. 



INDEX. 563 

Nightmare, 280. 

Nipples — Inflammation of, 408. 

Nitrick Acid— Tonick, 513. 

Noimaturals, 58. 

Nosology, 103. 

Nose — Stopped by Beans, &c. 399. 

Oak Black, bark of — Tonick, 513. — External Astrin- 
gent, 521. 

Old People — Require nourishing food, and should avoid 
fasting, 69. — Require retired or quiet rooms to sleep 
in, 75. 

Olfactory Nerve — In the Nose, 47. 

Omentum — Described, 39. 

Onanism, 264. 

Ointment — Mercurial, 503. — Of White Lead — External 
Astringent, 521. — Calamine, 522. — Of Armenian Bole, 
522. 

Ointments, 548. 

Oil Spearmint — Carminative Stimulant, 526. 

Oil Anise — Carminative Stimulant, 526. 

Oil Amber — Diffusible Stimulant, 508. — Antispasmod- 
ic^ 525. 

Orange Peel — Tonick, 513. 

Opium — Anodyne, 537. — Antihemorrhagick, 517.— An- 
tispasmodick, 522. 

Oil Wormseed — Vermifuge, 540. 

Oxyd Bismuth — Tonick, 514. 

Ophthalmicks, 534. 

Pancreatick Juice, concerned in digestion, 37. 

Palsy, 218. 

Passion Iliac, 248. — Observations on the Human Pas 
sions, 82. — Extremes of, meet in the same point, 83. 

Paraphymosis, 265. 

Palate — Properly called Uvula, 40. 

Paregorick — Expectorant, 497- — Anodyne, 539. 

Parturient Women — Introductory Remarks, 445.— Dis- 
eases of, 449.— Chills of, 449.— Afterpains of, 449.— 
Vomiting of, 450.— Puerperal Fever of, 450. — Con- 
cluding Advice to, 450. 

Physiological Sketches — Summary of, 5Q. 

Perspiration — Insensible ; 1 9. 



564 INDEX. 

Peripneumony, 179. 

Pleura— Described, 39. 

Pleurisy, 181. 

Pennyroyal — Stimulant Diaphoretick, 494. — Emmena- 
gogue, 531. 

Peppermint — Stimulant Diaphoretick, 494. — Essence 
of, 508. 

Peripneumonia Notha — A low disease of the Lungs, 180. 

Phlegmon — See biles, 407. 

Pnymosis, 265. 

Piles, 349. 

Pimples in the Face, 288. 

Pink Worm — Vermifuge, 540. 

Pine Cbips — Stimulant Alterative, 505. 

Pills — Laxative, 489. — Mercurial — Stimulant Altera- 
tive, 503. 

Poisons, 414. 

Posterior Chamber — See eye, structure of. 

Potato — Recommended, 65. 

Pox, or Lues, 336. 

Poke — Stimulant Alterative, 505. 

Poultices, 550. 

Powders of Camphor — Stimulant Diaphoretick, 493. — 
Nitrous Cooling, 502. — Diaphoretick, 493. — Kuhn's 
— Evacuant Alterative, 502. 

Pregnancy — Introductory Remarks on, 433. 

Pregnant Women — Advantages of exercise to such, 434. 
— Sick Stomach of, 436. — Heartburn of, 436. — Irregu- 
lar Bowels of, 437. — Longings of, 437. — Swelling 
and Pains in the Breasts of, 438. — Hysterick Fits 
and Fainting of, 439. — Wrong Position of the Womb, 
440. — Costiveness of, 441.— Swellings of the Legs 
and Belly of, 442.— Cough and Difficulty of Breath- 
ing of, 442. — Cramps of Legs, &c. 443.— Colick 
Pains of, 443. — Suppression of Urine of, 444. — In- 
continence of Urine of, 445. 

Prickly Heat, 290. 

Prickly Ash— Stimulant Alterative, 505. 

Prolapsus Uteri, 456, 

Pulse— Observations on, 85. — Sometimes hidden by the 
hardness of the Artery, 95.— -Tabular view of, 68. 



INDEX. 565 

Psoas Abscess, 406. 

Purging Pills, 487. — Purgative, 484. — With Aloes, 
487.— With Gamboge, 487.— Infusion, 487- 

Pupil — See eye, structure of. 

Quassia — Tonick, 513. 

Quinsy, 201. 

Rattlesnake — Bite of, 411. 

Red Gum of Children, 463.— Yellow, 462. 

Retina — See eye, 50. 

Rheumatism — Acute, 216. — Chronick, 319. 

Rhubarb — Purgative, 485. — Laxative, 489. — Syrup of, 
489.— Bitter Tincture of, 489. 

Rickets— Simple, 332.- Malignant, 333. 

Ringworm — See herpes. 

Riding on Horseback — Recommended, 81. 

Rochelle Salts — Purgative, 485. 

Rose — A species of Erysipelas, 200. 

Rose Water — Ophthalmick, 535. 

Ruptures, 372. 

Rue, the Juice — Vermifuge, 541. — Antispasmodick, 524. 

Saffron, English — Stimulant Diaphoretick, 494. — Car- 
minative Stimulant, 526. — Ophthalmick, 535. 

Salts — Glauber — Nitre — Febrifuge, 529.— Epsom— Ro- 
chelle — For their properties see list of medicines, 477. 

Sago — Nutrient, 542. 

Salt, Common — Vermifuge, 541. — Antihemorrhagick, 
517. 

Salt of Tartar — Lithontriptick, 533. — Carminative An- 
tacid, 527. 

Saline Mixture — Cooling, 498. — Febrifuge, 530. 

Sarsaparilla — Stimulant Alterative, 505» — See list of 
medicines. 

Sassafras — Stimulant Alterative, 505. 

Scarfskin — Remarks on, 17. — Skin, true, 17. 

Scarlatina Anginosa, 155. 

Scarifying — How performed, 103. 

Scaldhead, 287- 

Scalds and Burns, 374. 

Sclerotick Coat — See eye. 

Scarlet Fever, 200. 

Scurvy, common, 233. — Land Scurvy, 353. 



566 INDEX. 

Secretions — Remarks on, 82. 

Sense— Of Hearing, 47.— Of Taste, 45.— Of Touch, 
44. — Of Seeing, and the Eye Described, 49. — Of 
Smelling, 47. — Of the Senses in General, 52. 

Senna — Purgative, 486 — See list of medicines. 

Scrofuia — Introductory Remarks on, 331. — In the 
Glands, 334.— Malignant, 335. 

Seneka Snakeroot — Expectorant, 497« — See list of medi- 
cines. 

Shingles — See herpes. 

Sleep — Observations on, 74. 

Short Sighted — How occasioned, and the remedy, 5L< 

Shoes — Ought to be well oiled or waxed, 77- 

Smallpox, 165. 

Smell— Loss of, 302. 

Snakeroot, Virginian — Sudorifick, 492. — See list of 
medicines. 

Snakeroot, Seneka — Sudorifick, 493. — See list of medi- 
cines. 

Skin — Anatomy of, 17. — Sympathy between it and the 
Lungs, 20. 

Spectacles — Why useful, 51. 

Specks— Upon the Eye, 298. 

Spirit Turpentine — Diffusible Stimulant, 508. — See list 
of medicines. 

Spirit of Lavender, Compound — Diffusible Stimulant, 
507. — See list of medicines. 

Spirit of Mindererus — Diaphoretick, 495. 

Spirit of Hartshorn — Stimulant Diaphoretick, 494. — 
See list of medicines. 

Spirit Nitre, Sweet — Diaphoretick, 494. — See list of 
medicines. 

Spitting of Blood from the Stomach, 252. — From the 
Lungs, 250. 

Spirituous Drinks. — Should not be used early in the day, 
74. — Mere Spur upon Life, 71- 

Spirit of Camphor — Diffusible Stimulant, 510. 

Spinal Marrow — Described, 32. 

Spleen — Described, 38. 

Sore Eyes— Of Children, 463. 



INDEX. 567 

Soda— Carminative Antacid, 527*— Soda Water—Car- 
minative Stimulant, 526. 

Squills — Expectorant, 496. 

Squinting, 298. 

Submersion — See Drowning. 

Suffocation — From Various Causes, 389. — From Sub- 
stances in the Throat, 391. 

Sugar Lead— Antispasmodic]^ 52 5.— Antihemorrhagick, 
518.— Astringent, 520. 

Suppuratiou — See Inflammation, 401. 

Sudorificks, 491. 

Sulphur, Flowers of — Laxative, 488. — See list of medi- 
cines. 

Summer Purging of Children, 466. 

St. Vitus's Dance, 222. 

Stings of Insects, 413. 

Stone — See gravel. 

Stool Ball — See fistula in ano. 

Stonebruises, 410. 

Strangulation from Hanging, &c. 384. 

Strains, 359. 

Strangury, 294. 

Sweet Spirit of Nitre — Diuretick, 497. — See list of me- 
dicines. 

Swellings of the Testes, 263. 

Swoonings, or Faintings, 282. 

Syrup of Squills — Expectorant, 496. — See list of me- 
dicines. 

Syrup of Rhubarb, 489. — See list of medicines. 

Tamarind Water — Diluent Drink, 545. 

Tartar Emetick, 491. — See list of medicines. 

Taste, Sense of, 45. — Loss of, 302. 

Teeth, Names of, 21.— Teething of Children, 474. 

Tetanus, 219. 

Thorax or Chest, 39. 

Throat — Stopped dangerously, 391. 

Thrush of Children, 464. 

Tincture of Rhubarb, and Senna — Purgative, 487. 

Tincture Iron Muriated — Stimulant Alterative, 504. 

Tincture of Cantharides — Diffusible Stimulant, 508. 

Tincture of Assafcetida — Diffusible Stimulant, 508, 



568 INDEX. 

Tincture of Bark with Ether — Diffusible Stimulant, 50&, 

Tincture Guaiacum — Stimulant Alterative, 504. 

Tincture of Bark — Diffusible Stimulant, 509. 

Tinea Capitis, 287. 

Toast Water — Nutrient, 542. — Diluent Drink, 544 

Tonicks, 510. 

Touch, Sense of, 44.— Loss of, 303. 

Toothach, 271. 

Trees near a House — Unwholesome at Night, 60. 

Typhus Fever — Epidemical, 145 & 148. — From Local 
Causes, 207. 

Umbilical Region — Described, 40. 

Ureters — The passage from the Kidneys to the Blad- 
der, 38. 

Urine — Bloody, 252. — Retention of, 295. — Involuntary 
Passing of at Night, 295. 

Uterus — Prolapsus of, 456. — Inflammation of, 455. 

Uva Ursi — Lithontriptick, 533. — Astringent, 519. 

Valerian — Stimulant Diaphoretick, 494. — See list of me- 
dicines. 

Venereal Disease, 336. 

Veins — Described, 31. 

Vermifuges, 539. 

Vision — How Effected by the Eye, 50. 

Viscera— Of the Abdomen, 36.— Of the Chest or Tho- 
rax, 39. 

Viper— Bite of, 411. 

Vitriol, White— Emetick, 490. 

Vinegar of Squills — Stimulant Diuretick, 498. 

Vomits, 490. 

Vomiting from Disease of the Stomach, 257. — Of Par 
turient Women, 450. 

Waterbrash, 277. 

Watery Eye, 299. 

White Vitriol — Antemorrhagick, 518. — Astringent, 520. 

Weights, Apothecary, 483. 

White Oxyd of Bismuth — Tonick, 514. — Carminative 
Antacid, 528. 

Wines, Domestick — Ought to be more used, 72. 

Whey, of Cremor Tartar — Diluent Drink, 545. 

Wine-Stimulant Alterative, 506.--Antispasmodick, 524. 



INDEX. 569 

Wine Whey—Nutrient, 543.— Cordial Drink, 547. 

Windpipe — Sudden Stoppage of, 397. 

Worms, 293. 

Womb — Wrong Position of, 440. 

Worm Seed — Vermifuge, 540. 

Wound9 — Of those which heal by the first Intention, 

363.— Which should Suppurate, 367.— Which Bleed 

Dangerously, 368. 
Yaws, 340. 

Yellow Gum of Children, 462. 
Zink, Flowers of — Tonick, 514. 



1% 



GLOSSARY. 



ABSORBENTS— -Vessels which take up fluids from 
cavities, &c. in the human body. 

Abdomen — Belly. 

Alvine — Evacuations by stool. 

Anima Medica — The natural healing powers. 

Animal Functions — The voluntary functions of an ani- 
mal. 

Anus — The fundament. 

Alkalies — Potash, soda, hartshorn, lime, magnesia, &c. 

Aneurism — A disease of an artery, being a dilatation. 

Aqua Ammonia — Spirit of hartshorn. 

Asphyxia — A suspension of the heart's motion — faint- 
ing. 

Ascites — Dropsy of the belly. 

Arthritis Podagra — Gout of the feet. 

Atonick — Relaxed, enfeebled. 

Atrophy — A nervous consumption. 

Auricle — A sack-like appendage of the heart, through 
which the blood passes from the vein into the heart. 

Azote — The base of a deleterious air. 

Bistoury — A surgeon's knife. 

Bronchotomy — The operation of opening the windpipe. 

Buboes — Swellings in the glands of the groin. 

Cardialgia — Pain of the stomach seated about its upper 
orifice. 

Carbon — The base of foul air, found in wells, cellars, and 
caverns, &c. It may be discovered by putting down 
a lighted candle, if it burns, no carbonick air is pre- 



§7& GLOSSARY. 

sent. But if the candle goes out, it would be death 
to go down, till we have destroyed this foul air, which 
may be done by throwing down a quantity of fire; or a 
quantity of unslacked lime, observing to increase the 
quantity till a candle will burn, which is satisfactory 
evidence that there is no longer any danger. 

Catarrhal Affections — Colds, as cough, spitting, &c. 

Calculi — Stone-like substances found in the body. 

Chancers — Venereal ulcers on the penis. 

Cataplasms — Stimulant applications to the feet. 

Caries — Rottenness of the borite. 

Catheter — An instrument for drawing off the urine. 

Cephalagia Spasmodica — Sick headach. 

Chyle — Thin part of nourishment taken into the circu- 
lation. 

Clean Cloths — Clouts of children. 

Cloatick Vault — A necessary. 

Cellular Membrane — A net-like membrane which is lap- 
ped about the muscles, and other parts. 

Condyle — The knob-like ends of some of the bones. 

Contraindications — Something which forbids usual indi- 
cations. 

Diathesis — A condition of the body. 

Diaphrara — Partition between the belly and chest 

Dyspnoea — Difficulty of breathing. 

Emporium — A place where important transactions 
abound. 

Error Loci — Fluids wrong placed in the body. 

Electron — A figurative expression meaning something 
subtile. 

Encysted — Confined as in a bladder. 

Extravasated — Out of the proper vessels of the circu- 
lation. 

Fascia — A thin tendon. 

Feces — Excrement — Sediment. 

Fungi — Spongy lumps of flesh, similar to what is called 
proud flesh. 

Gastrick Liquor — Natural juice of the stomach. 

Galvanism — A species of electricity, obtained chymi- 
callv. 

Glans Penis — Extremity of the Penis, called the head. 



GLOSSARY. 573 

Halitus — A vapour found in the cavities of the body 
while it is warm. 

Hydrops Pectoris — Dropsy of the breast. 

Hydrocephalus — Dropsy of the head. 

Hydrocele — Dropsy of the scrotum. 

Incipient — Just forming, or beginning. 

Introsusception — One gut slipping into another. 

Laesions — -Wounds. 

Lusus Natural — Out of natural order. 

MammsB — Female breasts. 

Megrim — A painful giddiness. 

Meconium — Feces of unborn infants. 

Nocturnal Emissions — Loss of the seed at night. 

Nostrum — A random prescription. 

Onanism — Self-pollution. 

Oxygen — The base of vital air, of acids, and combined 
with many other substances. 

Olecranon — A part of the lower arm bone, and forms the 
hind part of the elbow. 

Ossifications — Flesh or tendons changed into something 
like bone. 

OEsophagus — the gullet. 

Ovaria — Bodies resembling eggs attached to the outside 
of the womb. 

Polypus — A disease of the nose, see index for loss of 
smell. 

Parotid Glands — Glands about the back ends of the un- 
der jaw. 

Pabulum — Support by way of nourishment. 

Papillae — Small points. 

Pancreatick Juice — A liquor poured into the gut just be- 
low the stomach, and is secreted by the sweet bread. 

Pandora — A heathen goddess supposed to deal out dis 
eases. 

Pelvis — Lower part of the body, formed by the bones of 
this part. 

Periosteum — The covering of the bones; described with 
the ligaments. 

Peritoneum — The lining of the abdomen. 

Perineum — Parts between the privates and anus. 

Pericardium — Purse-like sack enclosing the heart. 



$7% % GLOSSARY. 

Phlebotomy — Common bleeding. 

Pharynx — Upper orifice of the gullet. 

Priapisms — Painful erections of the penis. 

Primae Vise — Stomach and bowels. 

Pubis — The lower part of the body, covered with hair* 

Prepuce — Foreskin of the penis. 

Pneumonia — Inflammation of the chest. 

Rectum — The lower gut, being a short straight gut. 

Sanguiferous System — The blood vessels. 

Sphincter — A muscle which surrounds and closes some 
passage. 

Scarificator — An instrument used in cupping. 

Scrobiculus Cordis — Pit of the breast. 

Sensorium — That function of the brain which conveys 
sensation to the mind. 

Sinapisms — Applications of mustard to the feet. 

Scrotum — Sack of the privates. 

Subsultus Tendinum — Twitcbings of the tendons. 

Sui Generis — Of itself, unlike any thing else. 

Thyroid Cartilage — Part of the windpipe. 

Toncils — Glandular bodies in the back and upper part 
of the mouth. 

Typhus — A low state of fever, formerly called nervous. 

Torpor — A sickly state of languor. 

Typhoid — A fever a little above a typhus. 

Traumatick Tetanus — Locked jaw from wounds. 

Tympanites — Wind pent in the belly without the intes- 
tines. 

Tracheotomy — Operation of opening the windpipe. 

Tenesmus — A painful inclination but inability to stool. 

Trachea — Windpipe. 

Uterus — The womb. 

Uvula — A part of the mouth usually called the palate. 

Urethra — Water passage from the bladder outwards. 

Venesection — Common bleeding. 

Vertigo — A severe giddiness. 

Vice Vers'a — Contrariwise. 

Vires Naturae Medicatrises — The natural healing pow- 
ers. 

Vitrious Humour — See eye, structure of. 



ERRATUM. 

Page 865, line 4, for "parapisms" read priapisms. 



ADVERTISEMENT. 



John D. Toy, Baltimore, lias just printed for the au- 
thor, the first number of a series of "Lectures on Fevers 
in general: in which their causes, symptoms, and sana- 
tives are reviewed. With critical observations on cau- 
ses, pathology, animal life, kc. &c. By Horatio Gates 
Jameson, M. D. Honorary Member of the Medical So- 
ciety of Maryland, and one of the Surgeons to the Balti- 
more Hospital." — This Lecture contains anew and inge- 
nious classification of Fevers, and their Causes, in which 
the author evinces considerable reading, and a sound 
judgment. It is the outline of a system, which may be 
made useful to the Medical world: and it is to be hoped, 
that the Doctor will meet with sufficient encouragement 
from his brethren, to enable him to complete his design — 
which is. to publish twenty-four Lectures, of twenty-four 
pages each, at the price of twenty-five cents, a number, 
or four hundred and fiftv cents for the whole: the num- 
hers to appear f 'a8 circumstances shall justify." 

Portico. 



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